腹腔镜胃肠道手术患者术中双下肢抬高联合3M升温仪预防DVT的作用

目的探讨腹腔镜胃肠道手术过程中双下肢抬高联合3M升温仪对预防下肢深静脉血栓形成(DVT)的作用。方法回顾性分析2017年1月至2019年10月行腹腔镜胃肠道手术治疗患者198例,按术中血栓预防方法分为4组。A组应用双下肢抬高联合3M升温仪(n=55),B组应用双下肢抬高(n=51),C应用3M升温仪(n=48),D组为对照组(n=44,不采用双下肢抬高及3M升温仪)。采用彩色多普勒超声动态定点监测围术期下肢DVT形成及变化情况,分别在手术结束0h,24h,48h,72h,120h,>120h,行下肢DVT监测。结果A组形成率7.3%,B组15.7%、C组18.8%,D组38.6%,4组间比较差异有统计学意义(P=0.001);且A组明显低于D组(P<0.001)、B组明显低于D组(P=0.013)、C组明显低D组(P=0.026)。结论术中双下肢IPC联合3M升温仪的应用可有效预防腹腔镜胃肠道手术患者术后下肢DVT形成。

Objective To explore the effect of lower extremity elevation combined with double 3M thermometer on the prevention of lower extremity deep vein thrombosis(DVT)during laparoscopic gastrointestinal surgery.Methods A total of 198 patients treated by laparoscopic gastrointestinal surgery in the First Affiliated Hospital of Zhengzhou University from January 2017 to October 2019 were retrospective analyzed and divided into four groups according to the methods of intraoperative thromboprophylaxis:group A,B,C and D.A was the lower extremity elevation combined with 3M thermometer group(n=55),B was the lower extremity elevation group(n=51),C was the 3M thermometer group(n=48),and D was the control group(n=44,without both lower extremity elevation and 3M thermometer).Color Doppler ultrasound was used to monitor the formation and change of lower extremity DVT in perioperative period at 0 h,24 h,48 h,72 h,120 h,&GT at the end of surgery.At 120 h,the formation of DVT was monitored.Results The formation rate of group A minimum of 4(7.3%),followed by group B8 group C(15.7%),9(18.8%),17(38.6%),the highest for the group D on the whole had obvious differences,and differences statistically significant(P=0.001).Conclusion Intraoperative lower extremity IPC combined with 3M thermometer can effectively prevent the formation of lower extremity DVT in patients undergoing laparoscopic gastrointestinal surgery.