不同术中体位对患者下肢静脉血流及凝血指标的影响

Effects of four different positions on venous blood flow and coagulation indexes of lower limbs during operation

目的探讨患者术中给予4种不同体位对下肢静脉血流及凝血指标的影响。方法选取2018年1月至2021年1月实施手术的患者130例作为研究对象,根据术中体位不同分为仰卧位组(n=34)、俯卧位组(n=32)、侧卧位组(n=31)、截石位组(n=33),比较4组患者下肢静脉血流、凝血指标及下肢静脉血栓发生率。结果与其余3组比较,截石位组下肢双侧股静脉血流速度差明显更大,组间比较差异有统计学意义(P<0.05)。4组术前凝血酶原时间(PT)、活化部分凝血酶时间(APTT)比较无明显差异(P>0.05),与术前比较,4组术后PT、APTT明显缩短(P<0.05),与其余3组比较,截石位组时间明显更短,组间比较差异有统计学意义(P<0.05)。与其余3组比较,截石位组下肢静脉血栓发生率明显更高,组间比较差异有统计学意义(P<0.05)。结论不同手术体位造成的下肢静脉血流及凝血指标变化不同,其中截石位发生下肢静脉血栓的风险较高,应积极采取相应措施,防止下肢静脉血栓的形成。

Objective To investigate the influence of four different positions on venous blood flow and coagulation indexes of lower limbs.Methods A total of 130 surgically treated patients in our hospital from January 2018 to January 2021 were selected as the research objects,and they were divided into supine position group(n=34),prone position group(n=32),lateral position group(n=31)and stone position group(n=33)according to the different intraoperative postures.The lower extremity venous blood flow,coagulation indexes and the incidence of lower extremity venous thrombosis of the four groups were compared.Results Compared with the other three groups,the difference of blood flow velocity of lower extremity bilateral femoral vein before and after surgery in stone position group was significantly greater(P<0.05).There were no significant differences in preoperative prothrombin time(Pt)and activated partial thrombin time(APTT)among the four groups(P>0.05),which were significantly shorter after surgery(P<0.05).Compared with the other three groups,the surgery time of stone position group was significantly shorter(P<0.05).Compared with the other three groups,the incidence of lower extremity venous thrombosis in stone position group was significantly higher(P<0.05).Conclusion The changes of venous blood flow and coagulation indexes of lower extremity differ from different surgical positions,and the risk of venous thrombosis of lower extremity in stone position is higher.Corresponding measures should be taken to prevent the formation of venous thrombosis of lower extremity.