术中干预对肝癌切除患者术后住院期间下肢深静脉血栓形成的预防作用

Preventive effect of intraoperative intervention on lower extremity deep vein thrombosis during postoperative hospitalization in hepatectomy patients

目的探讨术中干预对肝癌切除患者术后住院期间下肢深静脉血栓(DVT)形成的预防作用。方法收集2021年3月至2023年2月新疆医科大学第一附属医院收治的136例肝癌患者的临床资料,按照是否在手术过程中采取针对性干预措施分为干预组(n=63)和对照组(n=73)。比较两组患者的手术相关指标、术后住院期间凝血功能复查结果、下肢DVT发生情况及其他并发症发生情况。结果干预组患者全身麻醉、术中低体温的比例均低于对照组患者,手术时长、下腔静脉阻断时间均短于对照组患者,差异均有统计学意义(P﹤0.05)。术后住院期间共12例(8.8%)患者发生下肢DVT,其中,干预组患者下肢DVT的发生率为3.2%(2/63),低于对照组患者的13.7%(10/63),差异有统计学意义(P﹤0.05)。术后凝血功能复查结果显示,两组患者的凝血酶原时间、活化部分凝血活酶时间及术后住院期间并发症发生率比较,差异均无统计学意义(P﹥0.05)。结论术中积极的针对性干预可以缩短手术时间和下腔静脉阻断时间,减少肝癌切除患者全身麻醉的使用,降低术中低体温及术后住院期间发生下肢DVT的风险,值得临床推广应用并进一步深入研究。

Objective To explore the preventive effect of intraoperative intervention on the formation of deep vein thrombosis(DVT)in the lower extremity during postoperative hospitalization in hepatectomy patients.Method Clinical data of 136 liver cancer patients admitted to the First Affiliated Hospital of Xinjiang Medical University from March 2021 to February 2023 were collected.The patients were divided into intervention group(n=63)and control group(n=73)based on whether targeted intervention measures were taken during surgery.The surgical related indicators,coagulation function follow-up results during postoperative hospitalization,incidence of lower extremity DVT during postoperative hospitalization,and other complications during postoperative hospitalization between two groups of patients were compared.Result The proportion of patients in the intervention group receiving general anesthesia and the incidence of hypothermia during surgery were lower than those in the control group,the surgical duration and the duration of inferior vena cava occlusion were also shorter than those in the control group,the differences were statistically significant(P<0.05).During the postoperative hospitalization,a total of 12 patients(8.8%)experienced lower extremity DVT.Among them,the incidence of lower extremity DVT in the intervention group was 3.2%(2/63),which was lower than the control group's 13.7%(10/63),the difference was statistically significant(P<0.05).Postoperative re-examination of coagulation function showed that there were no statistically significant differences between the two groups in terms of prothrombin time,activated partial thromboplastin time,and the incidence of postoperative complications during hospitalization(P>0.05).Conclusion Targeted interventions during surgery can effectively shorten the surgical duration and inferior vena cava occlusion time,reduce the use of general anesthesia and hypothermia during surgery and lower extremity DVT during hospitalization after surgery,which is worthy of clinical promotion and further in-depth research in clinical practice.