截石位膝关节屈曲角度对宫颈癌根治术患者下肢深静脉血流的影响研究  

Effect of knee flexion angle at lithotomy position on deep venous blood flow of lower limb in patients undergoing radical cervical cancer resection

作　　者：吴荷玉 赵诗雨 杨英 李莎[1] 姚冲 WU Heyu;ZHAO Shiyu;YANG Ying;LI Sha;YAO Chong(Operating Room,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei 430022,China)

机构地区：[1]华中科技大学同济医学院附属协和医院手术室,湖北武汉430022

出　　处：《现代医药卫生》2023年第16期2725-2728,共4页Journal of Modern Medicine & Health

基　　金：湖北省卫生健康委员会面上项目(WJ2021M229);华中科技大学第一临床学院教学改革研究项目(2022-31)。

摘　　要：目的探讨截石位不同膝关节屈曲角度对宫颈癌根治术患者下肢深静脉血流的影响。方法选取2022年5-12月在该院实施宫颈癌根治术患者120例,采用随机数字表法分为试验组和对照组,各60例,均采用截石位体位,对照组膝关节屈曲角度为110°,试验组膝关节屈曲角度为130°,观察2组患者手术前后超声下下肢股静脉和腘静脉血流速度差值、血管管径大小及凝血指标的变化。结果试验组患者手术前后左、右两侧股静脉、腘静脉血流速度差值均小于对照组,血管管径大于对照组,差异均有统计学意义(P<0.001);试验组术后24 h活化部分凝血酶原时间(APTT)、凝血酶原时间(PT)均高于对照组,D-二聚体(D-D)值小于对照组,差异均有统计学意义(P<0.001)。结论在宫颈癌根治术患者体位护理中,截石位膝关节屈曲130°相较于110°的血管管径变化更小,血流动力更稳定,D-D值变化更小,值得推广应用。Objective To investigate the effect of different knee flexion angles at lithotomy position on deep venous blood flow of lower limb in patients undergoing radical cervical cancer resection.Methods A total of 120 patients undergoing radical cervical cancer resection in this hospital from May to December 2022 were selected and divided into the observation group and the control group by random number table method,with 60 cases in each group.Lithotomy position was adopted in all cases.The knee flexion angle of the control group was 110°,and the knee flexion Angle of the observation group was 130°.The changes of blood flow velocity difference between femoral vein and popliteal vein,vascular diameter and coagulation index were observed before and after surgery in the two groups.Results The blood flow velocity difference of left and right femoral vein and popliteal vein in the observation group before and after surgery was smaller than that of the control group,and the vascular diameter was larger than that of the control group,the differences were statistically significant(P<0.001).The activated partial thromboplastin time(APTT)and prothrombin time(PT)24 h after operation in the observation group were higher than those in the control group,and the D-dimer(D-D)value was lower than that in the control group,with all statistical significance(P<0.001).Conclusion In the postural nursing of patients undergoing radical cervical cancer resection,knee flexion at lithotomy position of 130°shows smaller changes in vascular diameter,more stable hemodynamic,and smaller changes in D-D values,compared with 110°,which is worthy of promotion and application.

关 键 词：截石位 膝关节屈曲角度 宫颈癌根治术 下肢深静脉血栓 血流动力学 

分 类 号：R711[医药卫生—妇产科学] R713[医药卫生—临床医学]