超声评价经络弹力袜预防妇科手术后下肢深静脉血栓效果

Ultrasonic Evaluation of the Preventive Effect of Main and Collateral Channels Stretch Stockings on Lower Limb Deep Vein Thrombosis after Gynecological Operation

目的应用彩色多普勒超声评价经络弹力袜预防妇科盆腔术后下肢深静脉血栓(LEDVT)形成的效果。方法将2010年4月至2012年11月武汉市第三医院妇产科收治的210例行妇科盆腔术的患者根据就诊顺序编号及术后不同的处理措施分为三组,常规对照组70例,行常规下肢功能锻炼;普通弹力袜组70例,术后穿普通弹力袜及常规下肢功能锻炼;经络弹力袜组70例,术后穿经络弹力袜及常规下肢功能锻炼。彩色多普勒超声监测三组术前、术后24 h内下肢静脉血液流速及下肢深静脉血栓发生情况。结果三组的LEDVT发生率分别为15.71%、11.43%、2.86%(P<0.05)。三组术后双侧股总静脉血流速度比较差异无统计学意义;术后常规对照组左、右股浅静脉血流速度(cm/s)小于经络弹力袜组[(13.63±3.03)vs(15.71±0.81)]、[(13.36±2.69)vs(15.38±3.32)](P<0.05);术后普通弹力袜组左、右股浅静脉血流速度(cm/s)小于经络弹力袜组[(14.27±3.13)vs(15.71±0.81)]、[(14.61±3.33)vs(15.38±3.32)](P<0.05)。术后常规对照组左、右腘静脉血流速度(cm/s)小于经络弹力袜组[(13.34±2.72)vs(15.38±3.33)]、[(12.31±2.58)vs(14.37±3.19)](P<0.05);术后普通弹力袜组左、右腘静脉血流速度(cm/s)小于经络弹力袜组[(14.34±3.25)vs(15.38±3.33)]、[(13.26±2.93)vs(14.37±3.19)](P<0.05)。结论妇科盆腔手术后穿经络弹力袜能加快下肢深静脉的血液流速,有效预防妇科盆腔手术后LEDVT的发生。

Objective To apply color Doppler ultrasound to evaluate the effect of main and collateral channels stretch stockings to prevent lower extremity deep vein thrombosis （ LEDVT ） after gynecological pelvic surgery. Methods A total of 210 cases of gynecological pelvic surgery patients were randomly divided into three groups according to random number table method by the different postoperative treatment measures and medical registration number. Control group of 70 cases implemented normal lower limb functional exercise. 70 cases of common stretch stockings group wore ordinary stretch socks after surgery and done the exercise. Main and collateral channels stretch stockings group of 70 wore main and collateral channels stretch stockings and done the exercise. Color Doppler ultrasound examination was applied to monitor blood flow velocity in lower extremity venous and lower limb deep vein thrombosis in the three groups before operation and 24 h after surgery. Results The incidence of LEDVT of the three groups were 15.71% , 11.43% , 2.86% （ P 〈 0.05 ）. The postoperative bilateral femoral vein blood flow velocity were not statistically significantly different. The postoperative left and fight femoral superficial vein blood flow velocity of the control group were statistically significant lower than the main and collateral channels stretch stockings group [ （13.63 ±3.03） vs （15.71 ±0.81） ] ,[ （13.36 ±2.69） vs （15.38 ±3.32） ] （P 〈0.05） ;the postoperative left and right femoral superficial vein blood flow velocity of the common stretch stockings group were statistically significant lower than the main and collateral channels stretch stockings group[ （14.27 ± 3.13 ） vs （15.71 ±0.81）] ,[ （14.61 ±3.33） vs （15.38 ±3.32） ] （P〈0.05）. The postoperative left and fight popliteal vein blood flow velocity of the control group were statistically significant lower than the main and collateral channels stretch stockings group[ （ 13.34 ± 2.72 ） vs （ 15.38 ± 3.33 ） ], [ （ 12.31 ± 2.58 ） vs （ 14.37 ± 3.19） ] （ P 〈 0.05 ） ; The postoperative left and right popliteal vein blood flow velocity of t the common stretch stockings group were statistically significant lower than the main and collateral channels stretch stockings group[（14.34±3.25） vs （15.38 ±3.33）],[（13.26±2.93） vs （14.37±3.19）] （ P 〈 0.05 ）. Conclusion Main and collateral channels stretch stockings can increase lower limb deep vein blood flow velocity quickly in patients after gynecologic pelvic surgery,to effectively prevent LEDVT.