CAJ | 학술논문

目的：探讨彩色多普勒超声在间歇充气加压（IPC ）对直肠癌术后下肢深静脉血流状况检测中的应用价值。方法将220例直肠癌根治术后患者随机均分2组：对照组按常规术后处理，IPC组在常规术后处理的基础上加用IPC。于术前及术后1、3、5、7 d采用彩色多普勒超声分别检查患者双侧股总静脉、股浅静脉、股深静脉、腘静脉及胫后静脉血管管径和管腔内回声情况，测量其血流速度，计算平均血流速度及血流量，观察下肢有无深静脉血栓（DV T ）形成及形成部位、大小、范围、栓塞程度等。结果术后下肢 DV T 的发生率对照组为18例（16．4％），其中完全栓塞5例，不完全栓塞13例；IPC组为4例（3．6％），均是不完全栓塞。对照组下肢深静脉血流速度及血流量均小于IPC组（ P＜0．05）。结论彩色多普勒超声可以有效地检测出IPC对直肠癌术后下肢深静脉的血流变化，其所测量的血流动力学指标为临床评价直肠癌术后IPC疗效提供了直观、可靠的依据。
목적：탐토채색다보륵초성재간헐충기가압（IPC ）대직장암술후하지심정맥혈류상황검측중적응용개치。방법장220례직장암근치술후환자수궤균분2조：대조조안상규술후처리，IPC조재상규술후처리적기출상가용IPC。우술전급술후1、3、5、7 d채용채색다보륵초성분별검사환자쌍측고총정맥、고천정맥、고심정맥、객정맥급경후정맥혈관관경화관강내회성정황，측량기혈류속도，계산평균혈류속도급혈류량，관찰하지유무심정맥혈전（DV T ）형성급형성부위、대소、범위、전새정도등。결과술후하지 DV T 적발생솔대조조위18례（16．4％），기중완전전새5례，불완전전새13례；IPC조위4례（3．6％），균시불완전전새。대조조하지심정맥혈류속도급혈류량균소우IPC조（ P＜0．05）。결론채색다보륵초성가이유효지검측출IPC대직장암술후하지심정맥적혈류변화，기소측량적혈류동역학지표위림상평개직장암술후IPC료효제공료직관、가고적의거。
Objective To assess the value of color Doppler ultrasound (CDFI) in detection the state of blood flow in deep veins of lower limbs upon intermittent pneumatic compression (IPC) after rectal cancer resection . Methods A total of 220 patients undergoing rectal cancer resection were randomly di‐vided into non‐IPC group (control group ,n=110) and IPC group (n=110) . The control group received routine treatment after resection and the IPC group received IPC based on the routine treatment . The bi‐lateral blood caliber ,resonance echo and blood flow velocity of common femoral vein ,superficial femoral vein ,deep femoral vein ,popliteal vein and posterior tibial vein were examined by CDFI before operation and on 1‐,3‐,5‐and 7‐day after operation ,then the average blood flow velocity and blood flow volume were calculated . Meanwhile ,the happen of deep venous thrombosis (DVT ) and DVT'parts ,size ,range as well as embolism degree was observed . Results The incidence of lower limb DVT was 3 .6% (4/110) and 16 .4% (18/110) in IPC group and control group respectively . Those cases with lower limb DVT of IPC group were incomplete embolism . Among those 18 cases in control group ,5 of which had entirely embolism ,while the other 13 cases were suffered from incomplete embolism . The average blood flow ve‐locity of the deep veins of lower limb and blood flow volume in control group were lower than that of IPC group with significant difference (P< 0 .05) . Conclusions CDFI can be used to detect the change of blood flow in deep veins of lower limbs upon intermittent pneumatic compression (IPC) after rectal cancer resection . Thus CDFI can monitor the hemodynamics indexes of lower limb ,which provide visual and re‐liable information for evaluating the efficacy of IPC in patients after rectal cancer operation clinically .