彩色多普勒超声在检测直肠癌术后间歇充气加压下肢深静脉血流的应用

The Value of Color Doppler Ultrasound in Detection the State of Blood Flow in Deep Veins of Lower Limbs Upon Intermittent Pneumatic Compression after Rectal Cancer Resection

目的探讨彩色多普勒超声在间歇充气加压(IPC)对直肠癌术后下肢深静脉血流状况检测中的应用价值。方法将220例直肠癌根治术后患者随机均分2组:对照组按常规术后处理,IPC组在常规术后处理的基础上加用IPC。于术前及术后1、3、5、7d采用彩色多普勒超声分别检查患者双侧股总静脉、股浅静脉、股深静脉、腘静脉及胫后静脉血管管径和管腔内回声情况,测量其血流速度,计算平均血流速度及血流量,观察下肢有无深静脉血栓(DVT)形成及形成部位、大小、范围、栓塞程度等。结果术后下肢DVT的发生率对照组为18例(16.4%),其中完全栓塞5例,不完全栓塞13例;IPC组为4例(3.6%),均是不完全栓塞。对照组下肢深静脉血流速度及血流量均小于IPC组(P<0.05)。结论彩色多普勒超声可以有效地检测出IPC对直肠癌术后下肢深静脉的血流变化,其所测量的血流动力学指标为临床评价直肠癌术后IPC疗效提供了直观、可靠的依据。

Objective To assess the value of color Doppler ultrasound （CDFI） in detection the state of blood flow in deep veins of lower limbs upon intermittent pneumatic compression （IPC） after rectal nbsp;cancer resection . Methods A total of 220 patients undergoing rectal cancer resection were randomly di‐vided into non‐IPC group （control group ,n=110） and IPC group （n=110） . The control group received routine treatment after resection and the IPC group received IPC based on the routine treatment . The bi‐lateral blood caliber ,resonance echo and blood flow velocity of common femoral vein ,superficial femoral vein ,deep femoral vein ,popliteal vein and posterior tibial vein were examined by CDFI before operation and on 1‐,3‐,5‐and 7‐day after operation ,then the average blood flow velocity and blood flow volume were calculated . Meanwhile ,the happen of deep venous thrombosis （DVT ） and DVT＆#39;parts ,size ,range as well as embolism degree was observed . Results The incidence of lower limb DVT was 3 .6% （4/110） and 16 .4% （18/110） in IPC group and control group respectively . Those cases with lower limb DVT of IPC group were incomplete embolism . Among those 18 cases in control group ,5 of which had entirely embolism ,while the other 13 cases were suffered from incomplete embolism . The average blood flow ve‐locity of the deep veins of lower limb and blood flow volume in control group were lower than that of IPC group with significant difference （P〈 0 .05） . Conclusions CDFI can be used to detect the change of blood flow in deep veins of lower limbs upon intermittent pneumatic compression （IPC） after rectal cancer resection . Thus CDFI can monitor the hemodynamics indexes of lower limb ,which provide visual and re‐liable information for evaluating the efficacy of IPC in patients after rectal cancer operation clinically .