间歇式充气加压泵对腹腔镜直肠癌患者下肢深静脉血流变化的影响

Effects of intermittent pneumatic compression on blood flow of deep veins in lower limbs in rectal cancer patients with laparoscopic surgery

目的 探讨间歇式充气加压泵对腹腔镜直肠癌根治术患者术中下肢深静脉血流的影响效果。方法 选取2017年9月至2019年2月在上海交通大学医学院附属仁济医院东院接受腹腔镜直肠癌根治手术患者82例,随机分为试验组36例和对照组46例。对照组采用常规护理,试验组术中采用间歇式充气加压泵。2组均在截石位摆放前及手术结束双下肢复位前采用彩色多普勒超声诊断设备检测股静脉血管内径(mm)、最大血流速度(cm/s)及血流量(ml/s),比较分析2组患者临床资料与术前术后下肢静脉血流动力学变化的相关关系。结果 2组患者在术前术后股静脉流速、流量及管径差值的血流动力学变化比较,差异均有统计学意义(P<0.01)。结论 应用间歇式充气加压泵后能有效改善腹腔镜直肠癌根治患者围手术期下肢静脉的血液流变学变化,改善血液循环。通过血流动力学监测,为预防腔镜直肠癌根治患者术后下肢深静脉血栓的发生提供理论依据。

Objective To investigate the effects of intermittent pneumatic compression(IPC)on blood flow of deep veins in lower limbs in patients after laparoscopic radical resection of rectal cancer.Methods A total of 82 patients undergoing laparoscopic radical resection of rectal cancer were selected from September 2017 to February 2019 in Eastern Branch of Renji Hospital Affiliated to Medical School of Shanghai Jiaotong University,and the patients were randomly divided into experimental group(36 cases)and control group(46 cases).The control group received routine treatment,while the experimental group was treated with IPC during operation.The diameter(mm),the maximum blood flow velocity(cm/s)and blood flow(ml/s)of femoral vein were measured by color Doppler ultrasonography before placement of lithotomy position during operation and before lower limbs were laid down at the end of operation in both groups.The correlations between the hemodynamic change in femoral vein before and after operation and the clinical data of the two groups were compared and analyzed.Results There were significant differences in the changes before and after operation of velocity,flow and diameter of femoral vein between the two groups(P<0.01).Conclusion IPC can effectively improve the hemodynamic indexes of deep veins of lower limbs and blood circulation in patients undergoing laparoscopic radical rectal cancer.It is effective to prevent the occurrence of deep venous thrombosis of lower limbs after operation.