腹腔镜子宫内膜癌患者术后下肢深静脉血栓形成原因及护理对策

Risk factors and nursing strategies for lower limb deep vein thrombosis after laparoscopic endometrial carcinoma operation

目的探讨腹腔镜子宫内膜癌患者术后下肢深静脉血栓形成原因及护理对策。方法选取2017年1月至2019年12月间韩城市妇幼保健院收治的60例腹腔镜子宫内膜癌术后下肢深静脉血栓患者为观察组,另选取60例术后未发生下肢深静脉血栓患者为对照组,比较两组患者临床资料和肿瘤分期等,结合多因素Logistic回归分析明确高危因素,并制定针对性护理措施。结果两组患者年龄、淋巴结转移、手术时间、胆固醇、甘油三酯和纤维蛋白原比较,差异无统计学意义(P>0.05)。观察组患者高血压、糖尿病、血小板计数、体质量指数、术中出血量、肿瘤分化程度、肿瘤分期和D-二聚体均高于对照组,差异均有统计学意义(均P<0.05)。多因素Logistic回归分析,高血压、血小板计数、手术时间、术中出血量、肿瘤分化程度和肿瘤分期,均为下肢深静脉血栓形成高危因素(均P<0.05)。结论下肢深静脉血栓为腹腔镜子宫内膜癌术后常见并发症,高血压、手术时间长及出血量多等为高危因素,需做好针对性防范,加强术前教育、术后监测及防范,做好物理性及药物干预。

Objective To investigate the risk factors and nursing strategies for deep vein thrombosis in lower extremities after laparoscopic endometrial cancer surgery.Methods Sixty patients with lower extremity deep vein thrombosis after laparoscopic endometrial cancer treated at Hancheng Maternity and Child Health Hospital from January 2017 to December 2019 were selected as an observation group,and 60 individuals without lower extremity deep vein thrombosis after laparoscopic endometrial cancer were included in a control group.The clinical data and tumor staging were compared between the two groups.The multifactor logistic regression analysis was used to identify high-risk factors and develop targeted nursing strategies.Results There was no significant difference in age,lymph node metastases,duration of surgery,cholesterol,triglyceride and fibrinogen between the two groups(P>0.05).The incidence of hypertension and diabetes,platelet count,body mass index,intraoperative blood loss,tumor differentiation,tumor staging and D-dimer were higher in the observation group than in the control group(all P<0.05).Multivariate regression analysis showed that hypertension,platelet count,operation time,intraoperative blood loss,tumor differentiation,and tumor staging are high-risk factors for lower extremity deep vein thrombosis(all P<0.05).Conclusion Deep vein thrombosis of lower extremities is a common complication after laparoscopic endometrial cancer surgery.High blood pressure,long operation duration and major bleeding are high-risk factors.It is necessary to take precautions and strengthen preoperative education and postoperative monitoring as well as physical and drug interventions.