抗血栓弹力袜预防经尿道前列腺微创术后老年患者的深静脉血栓效果观察

Effect of Antithrombotic Elastic Stocking on Prevention of Deep Vein Thrombosis in Elderly Patients after Minimally Invasive Transurethral Prostate Surgery

目的探讨抗血栓弹力袜对预防经尿道前列腺微创术后患者深静脉血栓形成的效果。方法纳入2019年1月1日-2020年7月30日就诊于上海市第六人民医院金山分院泌尿外科行前列腺微创手术的114例患者为研究对象,随机分为对照组及观察组;对照组72例,采用常规预防措施;观察组42例,在对照组基础上加用抗血栓弹力袜预防。比较2组患者手术前1天及术后1周血小板计数(Plt)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)以及D-二聚体(D-D)等指标,比较2组术后1周深静脉血栓发生率。结果2组患者术后PT、APTT及D-二聚体较术前升高,FIB较术前降低,差异均有统计学意义(P<0.05);观察组患者术后1周PT、APTT高于对照组,D-二聚体低于对照组,差异均有统计学意义(P<0.05);对照组术后1周深静脉血栓发生率2.70%,观察组无1例发生。结论抗血栓弹力袜的应用可以有效改善经尿道前列腺微创术后的凝血功能,降低D-二聚体水平,预防深静脉血栓发生,值得进一步在临床推广应用。

Objective To observe the effect of antithrombotic elastic stocking on the prevention of deep vein thrombosis in patients after minimally invasive transurethral prostate surgery.Methods A total of 114 patients who underwent minimally invasive transurethral prostate surgery at the Department of Urology Surgery,Jinshan Branch,Sixth People's Hospital of Shanghai City fromJanuary 1,2019 to July 30,2020,were selected as the research subjects and divided randomly into control groups and observations.72 patients in the control group were treated with routine preventive measures;42 ones in the observation group were treated with antithrombotic elastic stocking on the basis of the control group.Platelet count(PLT),prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(FIB)and D-Dimer(D-D)were compared between the two groups one day before operation and one week after operation;the incidence of deep vein thrombosis at one week after operation were compared between the two groups.Results PT,APTT and D-dimer of the two groups after operation were higher than those before operation,and FIB was lower than that before operation,the difference was statistically significant(P<0.05).At one week after operation,PT and APTT of the observation group were higher than those of the control group,and the D-dimer was lower than that of the control group(P<0.05).The incidence of deep vein thrombosis in the control group was 2.70%one week after operation,and there was no case in the observation group.Conclusion The application of antithrombotic elastic stockings can effectively improve the coagulation function of patients after minimally invasive transurethral prostate surgery,reduce the level of D-dimer,and prevent the occurrence of deep vein thrombosis,which is worthy of further clinical application.