腹腔镜全子宫切除术后下肢静脉血栓形成危险因素分析及预防对策

Risk Factors Analysis and Prevention Measures on Lower Extremity Venous Thrombosis after Laparoscopic Total Hysterectomy

目的:探讨腹腔镜全子宫切除术后下肢静脉血栓(DVT)形成的危险因素及对策。方法:选取2013年5月-2015年4月本院收治的行腹腔镜全子宫切除术治疗患者159例作为研究对象,按照术后是否出现DVT分为DVT组56例和非DVT组103例,采用多因素Logistic分析法分析两组患者发生DVT的危险因素并提出相应的对策。结果:与非DVT组比较,DVT组患者手术时间较长,全麻率高,下肢静脉反复穿刺率高,术后活动时间<3 h,比较差异均有统计学意义(P<0.05);Logistic回归分析显示:麻醉方式、DVT疾病史、患者年龄、高脂血症、血小板升高及久躺久坐是发生DVT的危险因素。结论:腹腔镜全子宫切除术应缩短手术时间、尽量选择局麻、减少下肢静脉穿刺次数及鼓励患者多活动,对于有高危因素的患者应做好预防、术后随访工作,有利于防止DVT的形成。

Objective：To explore the risk factors and countermeasures for the formation of lower extremity venous thrombosis（DVT） after laparoscopic total hysterectomy.Method：A total of 159 cases of laparoscopic total hysterectomy from May 2013 to April 2015 in our hospital were selected as the research objects,they were divided into the DVT group of 56 cases and non DVT group of 103 cases according to whether or not happen DVT,the risk factors of DVT in two groups were analyzed by multiple factors logistic analysis,the corresponding countermeasures were put forward.Result：Compared with non DVT group,DVT group operation time was longer,general anesthesia was higher,lower extremity venous puncture rate was higher and postoperative activity time was less than 3 h,the differences were statistically significant（P〈0.05）.Logistic regression analysis showed that：anesthesia methods,DVT disease history,patient age, hyperlipemia, increased platelet and long sedentary were risk factor for DVT.Conclusion： Laparoscopic hysterectomy resection surgery should shorten the operation time,try to choose local anesthesia,reduce lower extremity venous puncture times and encourage patients to activities.For patients with high risk factors should be good prevention,follow-up work,it is conducive to prevent the formation of DVT.