中西医疗法在妇科腹腔镜术深静脉血栓预防中的应用

Application of Chinese and Western Medicines on Prevention of Deep Venous Thrombosis after Gynecological Laparoscopy Surgery

目的探讨中西医疗法在妇科腹腔镜术深静脉血栓预防中的应用效果。方法选取2015年12月—2016年12月在该院行妇科腹腔镜手术患者401例,分别于术前及术后24h采用Autar量表对患者进行评估,筛选出中危、高危患者共112例。按照区组随机化分为两组,对照组患者予妇科腹腔镜术后常规护理和治疗,观察组在对照组基础上联合穴位按摩。比较两组效果。结果术后第1天两组患者凝血4项、红细胞聚集指数及D-二聚体差异无统计学意义(P>0.05),术后第5天观察组患者的凝血酶时间、凝血酶原时间及活化部分凝血酶时间均长于对照组(P<0.05),红细胞聚集指数及D-二聚体低于对照组(4.50±0.82)vs.(5.41±0.93),(t红细胞聚集指数=5.4923,P<0.05)(0.36±0.09)mg/Lvs.(0.45±0.12)mg/L(tD-二聚体=4.4900;P<0.05);观察组患者股静脉、腘静脉的血流速度大于对照组,深静脉血栓形成发生率低于对照组,差异有统计学意义(6.45±2.09)cm/svs.(5.03±1.21)cm/s(t左下肢股静脉最大流速=4.4001,P<0.05),(5.91±2.14)cm/svs.(4.11±1.39)cm/s(t左下肢腘静脉最大流速=5.2786,P<0.05),(6.55±2.31)cm/svs.(4.97±1.16)cm/s,(t右下肢股静脉最大流速=4.5741,P<0.05),(5.89±2.07)cm/svs.(4.03±1.42)cm/s,(t右下直接腘静脉最大流速=5.5449;P<0.05)。结论中西医疗法可降低妇科腹腔镜术深静脉血栓形成的发生。

Objective To discuss the application of Chinese and Western medicines on prevention of deep venous thrombosis after gynecological laparoscopy surgery.Methods From Dec.2015 to Dec.2016,401 patients with gynecological laparoscopy surgery were evaluated by Autar scale before and 24 hours after surgery to screen 112 middle and high risk patients were divided into control group treated with usual care and treatment and research group treated with acupoint massage based on those treatments.The effect were compared between two groups.Results 1 day after surgery,the coagulation test,red cell assembling index and D-D have no differences between two groups (P>0.05).5 days after surgery,the thrombin time,prothrombin time and activated partial thromboplastin time,fibrinogen,red cell assembling index,D-D,flow velocity of femoral,popliteal veins and incidence of deep vein thrombosis in research group were better than in control (4.50±0.82) vs.(5.41±0.93)(t red cell assembling index=5.492 3,P<0.05),(0.36±0.09)mg/L vs.(0.45±0.12)mg/L (t D-Dimer=4.490 0,P<0.05),(6.45±2.09)cm/s vs.(5.03±1.21)cm/s (t Maximum velocity of femoral vein in left lower extremity=4.400 1,P<0.05),(5.91±2.14)cm/s vs.(4.11±1.39)cm/s,(t Maximum velocity of popliteal vein in left lower extremity=5.278 6,P<0.05),(6.55±2.31)cm/s vs.(4.97±1.16)cm/s,(t=Maximum velocity of femoral vein in right lower extremity=4.574 1,P<0.05),(5.89±2.07)cm/s vs.(4.03±1.42)cm/s (t Maximum velocity of right lower popliteal vein=5.544 9;P<0.05).Conclusion Chinese and Western medicines could reduce the incidence of deep venous thrombosis after gynecological laparoscopy surgery.