术中干预对腹部恶性肿瘤术后并发下肢深静脉血栓的预防效果  

Preventive effect of intraoperative intervention on lower extremity deep vein thrombosis after abdominal malignant tumor surgery

作　　者：居佩佩 刘艳 叶飞 陈银兵 Ju Peipei;Liu Yan;Ye Fei;Chen Yinbing(Operation Room,Hai'an People's Hospital,Hai'an 226600,Jiangsu,China;Department of Thoracic Surgery,Hai'an People's Hospital,Hai'an 226600,Jiangsu,China;Department of Vascular Surgery,Hai'an People's Hospital,Hai'an 226600,Jiangsu,China)

机构地区：[1]海安市人民医院手术室,江苏海安226600 [2]海安市人民医院胸外科,江苏海安226600 [3]海安市人民医院血管外科,江苏海安226600

出　　处：《血管与腔内血管外科杂志》2023年第10期1255-1259,共5页Journal of Vascular and Endovascular Surgery

基　　金：南通市市级科技计划项目(JCZ20108)。

摘　　要：目的 探讨术中干预对腹部恶性肿瘤术后并发下肢深静脉血栓的预防效果。方法 收集2020年9月至2022年8月于海安市人民医院接受恶性肿瘤根治术的128例腹部恶性肿瘤患者的临床资料,按照是否术中给予针对术后下肢深静脉血栓的预防措施将患者分为对照组(n=67,常规进行手术和术中管理)和干预组(n=61,在对照组基础上增加针对下肢深静脉血栓的预防措施)。结果 两组患者的恶性肿瘤部位、术中出血量比较,差异均无统计学意义(P﹥0.05)。干预组患者的手术时间短于对照组患者,全身麻醉的使用率、术中低体温的发生率及术后D-二聚体水平升高的比例均低于对照组患者,差异均有统计学意义(P﹤0.05);进一步的超声检查结果显示,干预组患者下肢深静脉血栓的发生率低于对照组患者,差异有统计学意义(P﹤0.05)。术后,两组患者的凝血酶原时间、活化部分凝血活酶时间及并发症发生率比较,差异均无统计学意义(P﹥0.05)。结论 术中干预可有效降低腹部恶性肿瘤患者发生下肢深静脉血栓的风险,同时没有增加并发症的发生风险,值得临床推广并深入研究。Objective To investigate the preventive effect of intraoperative intervention on lower extremity deep vein thrombosis after abdominal malignant tumor surgery.Method The clinical data of 128 patients with abdominal malignant tumors who underwent radical resection of malignant tumors at Hai'an People's Hospital from September 2020 to August 2022 were collected.The patients were divided into the control group(n=67,routine surgery and intraoperative management)and the intervention group(n=61,preventive measures against deep vein thrombosis based on the control group)according to whether preventive measures against postoperative deep vein thrombosis of the lower extremity were given intraoperatively.Result There were no statistically significant differences in the location of malignant tumors and intraoperative blood loss between the two groups of patients (P>0.05). The operation time of the patients in the intervention group was shorter than that of the patients in the control group, and the usage rate of general anesthesia, the incidence rate of intraoperative hypothermia, the proportion of patients with increased D-dimer levels after surgery in the intervention group were all lower than those of the patients in the control group, and the differences were statistically significant (P<0.05). Further ultrasound examination results showed that the incidence rate of lower extremity deep vein thrombosis of patients in the intervention group was lower than that of patients in the control group, and the difference was statistically significant (P<0.05). After the surgery, there was no statistically significant difference in prothrombin time, activated partial thromboplastin time, and incidence rate of complications between the two groups of patients (P>0.05). Conclusion The intraoperative intervention could effectively reduce the risk of lower extremity deep vein thrombosis in patients with abdominal malignant tumors without increasing the risk of complications. It is worthy of clinical promotion and further research.

关 键 词：腹部 恶性肿瘤 术中干预 下肢深静脉血栓 预防 

分 类 号：R543[医药卫生—心血管疾病]