间歇充气装置与医用弹力袜预防腹腔镜手术患者下肢深静脉血栓效果比较
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摘要
目的比较间歇充气装置与医用弹力袜预防腹腔镜手术患者下肢深静脉血栓的效果。方法将腹腔镜胃肠道肿瘤切除手术患者200例按照时间顺序分组,对照组(2016年1月至2017年1月)100例术中采用医用弹力袜预防深静脉血栓,观察组(2017年2月至2018年2月)100例术中使用间歇充气装置,观察两组下肢深静脉血栓发生率、持续时间及手术前后凝血/纤溶指标变化。结果观察组下肢深静脉血栓发生率显著低于对照组,下肢深静脉血栓持续时间显著短于对照组(P<0.05,P<0.01)。观察组手术开始2 h PT、tPA-Ag值显著高于对照组(均P<0.01);术后24 h PT值显著低于对照组(P<0.01),ATTP、tPA-Ag值与对照组差异无统计学意义(均P>0.05)。结论术中间歇充气可有效降低患者下肢深静脉血栓发生率,改善凝血/纤溶指标。
Objective To compare the effect of using intermittent inflation devices and medical elastic stockings during laparoscopic surgery on the prevention of deep vein thrombosis(DVT) in the lower extremities.Methods A total of 100 patients who wore medical elastic stockings during laparoscopic gastrointestinal tumor resection to prevent DVT with in the period from January 2016 to January 2017 were selected as the control group. Another 100 patients using an intermittent inflation device during the same kind of surgery from February, 2017 to February, 2018 were enrolled into the observation group. The incidence rates of DVT in the lower extremities, length of time of DVT, and the changes of coagulation/fibrinolysis index before and after surgery in the 2 groups were compared.Results The incidence rate of DVT in the observation group was lower, and the length of time of DVT was shorter, than those in the control group(P<0.05,P<0.01).The values of PT and tPA-Ag in the observation group were significantly higher than those in the control group 2 h after the start of surgery(P<0.01 for both); the values of PT at 24 hours after the surgery in the observation group was significantly lower than the control group(P<0.01), while the values of ATTP, tPA-Ag had no significant difference between the 2 groups(P>0.05 for all).Conclusion Intraoperative intermittent inflation can effectively reduce the incidence rate of DVT in the lower extremities and improve the coagulation/fibrinolysis index.
Objective To compare the effect of using intermittent inflation devices and medical elastic stockings during laparoscopic surgery on the prevention of deep vein thrombosis(DVT) in the lower extremities.Methods A total of 100 patients who wore medical elastic stockings during laparoscopic gastrointestinal tumor resection to prevent DVT with in the period from January 2016 to January 2017 were selected as the control group. Another 100 patients using an intermittent inflation device during the same kind of surgery from February, 2017 to February, 2018 were enrolled into the observation group. The incidence rates of DVT in the lower extremities, length of time of DVT, and the changes of coagulation/fibrinolysis index before and after surgery in the 2 groups were compared.Results The incidence rate of DVT in the observation group was lower, and the length of time of DVT was shorter, than those in the control group(P<0.05,P<0.01).The values of PT and tPA-Ag in the observation group were significantly higher than those in the control group 2 h after the start of surgery(P<0.01 for both); the values of PT at 24 hours after the surgery in the observation group was significantly lower than the control group(P<0.01), while the values of ATTP, tPA-Ag had no significant difference between the 2 groups(P>0.05 for all).Conclusion Intraoperative intermittent inflation can effectively reduce the incidence rate of DVT in the lower extremities and improve the coagulation/fibrinolysis index.
引文
[1] 陈黎敏,徐海燕,顾婷婷,等.加温弹力袜预防后路腰椎椎间融合术患者下肢深静脉血栓形成和低体温的效果[J].中华现代护理杂志,2018,24(3):344-349.
[2] 王伟伟.护理风险预警监控在预防下肢深静脉血栓中的应用效果[J].实用临床护理学电子杂志,2018,3(9):132,197.
[3] Jensen C T, Chahin A, Amin V D, et al.Qualitative slow blood flow in lower extremity deep veins on doppler sonography: quantitative assessment and preliminary evaluation of correlation with subsequent deep venous thrombosis development in a tertiary care oncology center[J].J Ultrasound Med,2017,36(9):1867-1874.
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[5] 江蕙君.Autar量表在骨科下肢深静脉血栓形成风险分级评估中的应用[J].护理与康复,2018,17(1):49-50.
[6] 丁立朋,韩志南,张梅,等.AngioJet血栓抽吸导管行下肢深静脉血栓形成介入治疗的护理体会[J].齐鲁护理杂志,2018,24(3):94-96.
[7] 汪晖,方汉萍,刘洪娟,等.梯度压力弹力袜预防下肢深静脉血栓的研究进展[J].中国护理管理,2017,17(11):1458-1463.
[8] 夏丽霞,陈红,赵体玉.弹力绷带预防腔镜膀胱截石位手术患者下肢深静脉血栓[J].护理学杂志,2015,30(10):50-51.
[9] Sobreira M L, Bertanha M, Jaldin R G, et al.The prevalence of and predictors to indicate bilateral venous duplex ultrasound testing to detect contralateral asymptomatic lower extremity deep venous thrombosis in patients with acute symptomatic lower extremity deep venous thrombosis[J].J Vasc Surg Venous Lymphat Disord,2016,4(2):172-178.
[10] Lakhter V, Zack C J, Brailovsky Y, et al.Sex diffe-rences in utilization and outcomes of catheter-directed thrombolysis in patients with proximal lower extremity deep venous thrombosis-Insights from the Nationwide Inpatient Sample[J].Vasc Med,2017,22(2):128-134.
[11] 赵艳军,董丽,王盈.专科化护理对颅脑外伤术后昏迷患者下肢深静脉血栓形成的预防[J].中国临床护理,2017,9(6):494-496.
[12] 颜彦,张智.即时量化评估的阶梯式超前护理预防卧床老年患者深静脉血栓的效果[J].国际护理学杂志,2018,37(7):916-919.
[13] Lin M, Hsieh J C F, Hanif M, et al.Evaluation of thrombolysis using tissue plasminogen activator in lower extremity deep venous thrombosis with concomitant femoral-popliteal venous segment involvement[J].J Vasc Surg Venous Lymphat Disord,2017,5(5):613-620.
[2] 王伟伟.护理风险预警监控在预防下肢深静脉血栓中的应用效果[J].实用临床护理学电子杂志,2018,3(9):132,197.
[3] Jensen C T, Chahin A, Amin V D, et al.Qualitative slow blood flow in lower extremity deep veins on doppler sonography: quantitative assessment and preliminary evaluation of correlation with subsequent deep venous thrombosis development in a tertiary care oncology center[J].J Ultrasound Med,2017,36(9):1867-1874.
[4] 李敏,柏亚妹,刘云.穴位电刺激联合间歇性充气加压预防颅脑损伤患者下肢深静脉血栓形成[J].护理学杂志,2017,32(22):10-12.
[5] 江蕙君.Autar量表在骨科下肢深静脉血栓形成风险分级评估中的应用[J].护理与康复,2018,17(1):49-50.
[6] 丁立朋,韩志南,张梅,等.AngioJet血栓抽吸导管行下肢深静脉血栓形成介入治疗的护理体会[J].齐鲁护理杂志,2018,24(3):94-96.
[7] 汪晖,方汉萍,刘洪娟,等.梯度压力弹力袜预防下肢深静脉血栓的研究进展[J].中国护理管理,2017,17(11):1458-1463.
[8] 夏丽霞,陈红,赵体玉.弹力绷带预防腔镜膀胱截石位手术患者下肢深静脉血栓[J].护理学杂志,2015,30(10):50-51.
[9] Sobreira M L, Bertanha M, Jaldin R G, et al.The prevalence of and predictors to indicate bilateral venous duplex ultrasound testing to detect contralateral asymptomatic lower extremity deep venous thrombosis in patients with acute symptomatic lower extremity deep venous thrombosis[J].J Vasc Surg Venous Lymphat Disord,2016,4(2):172-178.
[10] Lakhter V, Zack C J, Brailovsky Y, et al.Sex diffe-rences in utilization and outcomes of catheter-directed thrombolysis in patients with proximal lower extremity deep venous thrombosis-Insights from the Nationwide Inpatient Sample[J].Vasc Med,2017,22(2):128-134.
[11] 赵艳军,董丽,王盈.专科化护理对颅脑外伤术后昏迷患者下肢深静脉血栓形成的预防[J].中国临床护理,2017,9(6):494-496.
[12] 颜彦,张智.即时量化评估的阶梯式超前护理预防卧床老年患者深静脉血栓的效果[J].国际护理学杂志,2018,37(7):916-919.
[13] Lin M, Hsieh J C F, Hanif M, et al.Evaluation of thrombolysis using tissue plasminogen activator in lower extremity deep venous thrombosis with concomitant femoral-popliteal venous segment involvement[J].J Vasc Surg Venous Lymphat Disord,2017,5(5):613-620.
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