优化术中管理对老年骨科手术患者住院期间发生下肢深静脉血栓的预防作用  

Preventive effect of intraoperative modified management on lower extremity deep vein thrombosis in elderly orthopedic surgery patients during hospitalization

作　　者：丁旭[1] 曹霞 王鹰 陈雷 Ding Xu;Cao Xia;Wang Ying;Chen Lei(Department of Anesthesiology,Fuxing Hospital Affiliated to Capital Medical University,Beijing 100038,China;Department of Vascular Surgery,Fuxing Hospital Affiliated to Capital Medical University,Beijing 100038,China)

机构地区：[1]首都医科大学附属复兴医院麻醉科,北京100038 [2]首都医科大学附属复兴医院血管外科,北京100038

出　　处：《血管与腔内血管外科杂志》2024年第12期1511-1514,1528,共5页Journal of Vascular and Endovascular Surgery

摘　　要：目的探讨优化术中管理对老年骨科手术患者住院期间发生下肢深静脉血栓(LEDVT)的预防作用。方法收集2023年1月至2024年1月于首都医科大学附属复兴医院接受骨科手术的212例老年患者的临床资料,将2023年1—6月接受常规术中管理措施的患者作为对照组(n=103),将2023年7月至2024年1月接受针对LEDVT预防的优化术中管理措施的患者作为观察组(n=109)。比较两组患者的病情、麻醉信息、手术情况和住院期间结局。结果两组患者的手术部位、疾病性质、术后镇痛泵使用情况、手术时间、术中出血量和术中输血情况比较,差异均无统计学意义(P﹥0.05)。观察组患者术中使用全身麻醉的比例、术中低体温和住院期间LEDVT的发生率均低于对照组患者,差异均有统计学意义(P﹤0.05)。结论有针对性的优化术中管理可以降低老年骨科手术患者术后住院期间发生LEDVT的风险,降低术中低体温的发生率,同时不增加手术时间和出血风险。Objective To investigate the preventive effect of intraoperative modified management on lower extremity deep vein thrombosis(LEDVT)in elderly orthopedic surgery patients during hospitalization.Method The clinical data of 212 elderly patients who underwent orthopedic surgery at the Fuxing Hospital Affiliated to Capital Medical University from January 2023 to January 2024 were collected.Among them,patients who received routine intraoperative management from January to June 2023 were selected as the control group(n=103),and patients who received intraoperative modified management for LEDVT prevention from July 2023 to January 2024 were selected as the observation group(n=109).The disease situation,anesthesia information,surgical progress,and hospital outcomes between two groups of patients were compared.Result There were no statistically significant differences in the surgical site,disease nature,postoperative analgesic pump usage,surgical time,intraoperative blood loss,and intraoperative blood transfusion between the two groups of patients(P>0.05).The proportion of patients in the observation group who received general anesthesia during surgery,the incidence of hypothermia during surgery,and the incidence of LEDVT during hospitalization were all lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Targeted intraoperative modified management can significantly reduce the risk of LEDVT during hospitalization in elderly orthopedic surgery patients,lower the incidence of hypothermia during surgery,without increasing surgical duration and bleeding risk.

关 键 词：术中管理 老年 骨科手术 下肢深静脉血栓 

分 类 号：R543[医药卫生—心血管疾病]