间歇充气加压装置对老年子宫内膜癌术后患者下肢静脉血流速度及凝血功能的影响

Analysis of the Effect of Intermittent Pneumatic Compression Device on Blood Flow Velocity and Coagulation Function of Lower Limb Vein in Elderly Patients with Endometrial Carcinoma after Operation

目的:探讨老年子宫内膜癌(UCEC)术后应用间歇充气加压装置的效果及其对下肢静脉血流速度及凝血功能的影响。方法:选取2021年1月—2023年1月在南阳医学高等专科学校第一附属医院进行手术治疗的老年UCEC患者123例,按照随机数表法将其分为对照组(n=61)和研究组(n=62),对照组应用快速康复外科理念模式实施围术期管理,研究组在此基础上增加间歇充气加压泵(IPCD)装置,对比两组患者深静脉血栓形成(DVT)发生率,下肢静脉血流速度、下肢肿胀程度、凝血指标。结果:干预后,研究组DVT发生率为8.06%,低于对照组的21.31%,差异有统计学意义(χ^(2)=4.319,P<0.05);研究组下肢髂外静脉、股静脉、腘静脉血流速度均大于对照组,差异有统计学意义(t值分别为-4.491、-3.752和-4.769,P值均<0.05);研究组大腿周径与小腿周径均小于对照组,差异有统计学意义(t值分别为6.568和3.953,P值均<0.05);研究组D-二聚体、血浆纤维蛋白原值水平均低于对照组,凝血酶原时间、活化部分凝血活酶时间均长于对照组,差异有统计学意义(t值分别为4.799、5.713、2.019和3.247,P值均<0.05)。结论:IPCD有助于改善老年UCEC患者的血液高凝状态,加快下肢血流速度,从而改善患者下肢水肿状况,有效预防DVT的发生,具有临床推广价值。

OBJECTIVE To investigate the effect of intermittent pneumatic compression device after operation for senile endome⁃trial carcinoma(UCEC)and its mechanism on blood flow velocity and coagulation function of lower limb veins.METHODS A total of 123 elderly patients undergoing UCEC surgical treatment in our department from January of 2021 to January of 2023 were selected and divided into control group and observation group according to random number table method.In the control group,61 patients re⁃ceived perioperative management based on the concept model of rapid rehabilitation surgery,and in the observation group,62 pa⁃tients received intermittent aerated pressure pump(IPCD).The incidence of DVT,lower limb venous blood flow velocity,lower limb swelling degree and coagulation index were compared between the two groups.RESULTS After intervention,the incidence of DVT in the observation group was 8.06%lower than 21.31%in the control group(χ^(2)=4.319,P<0.05).The blood flow velocity of the external iliac vein,femoral vein and popliteal vein in the lower limb of the observation group was greater than that of the control group(t=-4.491,-3.752,-4.769,P<0.05),and the circumference diameter of the thigh and leg in the observation group were smaller than that of the control group(t=6.568,3.953,P<0.05).The levels of D-dimer and plasma fibrinogen in observation group were lower than those in control group,and the prothrombin time and activated partial thromboplastin time in observation group were longer than those in control group(t=4.799,5.713,2.019,3.247,P<0.05).CONCLUSION IPCD is helpful to improve blood hypercoagulabil⁃ity in elderly UCEC patients,speed up lower limb blood flow,improve lower limb edema,and effectively prevent DVT,which has clinical promotion value.