下肢静脉血栓操与踝泵运动用于预防肺癌根治术后深静脉血栓形成的效果差异

The difference between lower limb venous thrombosis exercise and ankle pump exercise in preventing deep venous thrombosis after radical resection of lung cancer

目的 观察下肢静脉血栓操与踝泵运动用于预防肺癌根治术后下肢深静脉血栓形成(deepvenous thrombosis,DVT)的效果差异。方法 选取2019年12月至2022年3月于台州市中心医院行肺癌根治术的98例患者,依据患者术后DVT预防措施的不同将其分为血栓操组(n=61)和踝泵组(n=37);血栓操组患者采用下肢静脉血栓操预防DVT,踝泵组患者采用踝泵运动预防DVT,比较两组患者下肢血流动力学指标、Wells评分、患者疼痛程度及DVT发生率。结果 两组患者术后48h的股静脉血流峰值、平均血流速度均显著低于本组术前(P<0.01),血栓操组患者术后48h的股静脉血流峰值显著高于踝泵组(P<0.01);两组患者术前、术后48h的Wells评分危险程度分布情况比较差异均有统计学意义(P<0.01),血栓操组患者术后48h的DVT危险程度低于踝泵组(P<0.05);血栓操组患者术后48h的疼痛强度及疼痛影响均显著低于踝泵组及本组术前(P<0.05);两组患者的DVT总发生率比较差异无统计学意义(P>0.05)。结论 下肢静脉血栓操对肺癌根治术患者术后DVT预防具有积极作用,可提升股静脉血流峰值、减轻DVT风险及术后疼痛程度,但与踝泵运动相比并未降低术后7d的DVT相关并发症发生率。

Objective To observe the effect difference between lower limb venous thrombosis exercise and ankle pump exercise in preventing deep venous thrombosis(DVT) of lower limb after radical resection of lung cancer.Methods From December 2019 to March 2022, 98 patients who underwent radical resection of lung cancer in Taizhou Central Hospital were divided into thrombus exercise group(n=61) and ankle pump group(n=37) according to the different preventive measures of DVT after operation. Patients in thrombotic exercise group were treated with lower limb venous thrombotic exercise to prevent DVT. Patients in ankle pump group were treated with ankle pump exercise to prevent DVT. The lower limb hemodynamic indexes, Wells score, pain degree and incidence of DVT were compared between the two groups. Results The peak velocity of femoral vein blood flow and average blood flow velocity at 48 hours after operation was significantly lower in both groups than that before operation(P<0.01). The peak velocity of femoral vein blood flow at 48 hours after operation in thrombotic exercise group was significantly higher than that in ankle pump group(P<0.01). There were statistically significant differences in the risk degree distribution of Wells score 48 hours before and after operation between the two groups(P<0.01). The risk degree of DVT in thrombus exercise group at 48 hours after operation was lower than that in ankle pump group(P<0.05). The pain intensity and effect of thrombus exercise group at 48 hours after operation were significantly lower than those of ankle pump group and this group before operation(P<0.05). There was no significant difference in the total incidence of DVT between the two groups(P>0.05). Conclusion Lower limb venous thrombosis exercise has a positive effect on postoperative DVT prevention in patients undergoing radical lung cancer surgery. It can increase the peak value of femoral vein blood flow and reduce the risk of DVT and postoperative pain, but it does not reduce the incidence of DVT-related complications 7 days after operation compared with ankle pump exercise.