现代临床护理
現代臨床護理
현대림상호리
MODERN CLINICAL NURSING
2013年
7期
46-48,49
,共4页
苏润霞%梁月娥%吴永红%彭嘉怡
囌潤霞%樑月娥%吳永紅%彭嘉怡
소윤하%량월아%오영홍%팽가이
妇科%腹腔镜手术%间断性气囊加压法%深静脉血栓
婦科%腹腔鏡手術%間斷性氣囊加壓法%深靜脈血栓
부과%복강경수술%간단성기낭가압법%심정맥혈전
gynaecology%laparoscopic surgery%intermittent pneumatic compression%deep phlebothrombosis
目的探讨术中间歇性气囊加压法（intermittent pneumatic compression method，IPC）在妇科腹腔镜患者中的应用效果。方法将200例不孕症行腹腔探查患者分为观察组和对照组，每组各100例。两组均在全身麻醉和膀胱截石位下行腹腔镜手术，术中对照组不采用任何干预措施，观察组采用 IPC。比较两组患者术前、术后第1 d 和第3 d 凝血功能指标；术前、手术后30 min、术后第1 d 股静脉血流速度；术后3个月深静脉血栓（deep vein thrombosis，DVT）发生率的差异。结果术后3个月对照组发生 DVT 12例，观察组2例，两组比较，χ2＝6.22，P＜0.05，差异具有统计学意义。观察组患者术后第1 d 凝血酶原时间（prothrombintime，PT）和凝血活酶时间（activated par-tialthrom boplastin time，APTT）高于对照组，术后第1 d 和第3 d 纤维蛋白原（human fibrinogen，FIB）低于对照组（均 P＜0.05）。术后30 min 和术后24 h 观察组患者股静脉血流速度大于对照组，两组比较，差异具有统计学意义（均 P＜0.05）。观察组各时间点股静脉血流速度比较，F＝1.94，P＞0.05，差异无统计学意义。结论IPC 应用于腹腔镜手术是安全有效的，能改善下肢血液循环和预防下肢 DVT 的发生，值得临床推广应用。
目的探討術中間歇性氣囊加壓法（intermittent pneumatic compression method，IPC）在婦科腹腔鏡患者中的應用效果。方法將200例不孕癥行腹腔探查患者分為觀察組和對照組，每組各100例。兩組均在全身痳醉和膀胱截石位下行腹腔鏡手術，術中對照組不採用任何榦預措施，觀察組採用 IPC。比較兩組患者術前、術後第1 d 和第3 d 凝血功能指標；術前、手術後30 min、術後第1 d 股靜脈血流速度；術後3箇月深靜脈血栓（deep vein thrombosis，DVT）髮生率的差異。結果術後3箇月對照組髮生 DVT 12例，觀察組2例，兩組比較，χ2＝6.22，P＜0.05，差異具有統計學意義。觀察組患者術後第1 d 凝血酶原時間（prothrombintime，PT）和凝血活酶時間（activated par-tialthrom boplastin time，APTT）高于對照組，術後第1 d 和第3 d 纖維蛋白原（human fibrinogen，FIB）低于對照組（均 P＜0.05）。術後30 min 和術後24 h 觀察組患者股靜脈血流速度大于對照組，兩組比較，差異具有統計學意義（均 P＜0.05）。觀察組各時間點股靜脈血流速度比較，F＝1.94，P＞0.05，差異無統計學意義。結論IPC 應用于腹腔鏡手術是安全有效的，能改善下肢血液循環和預防下肢 DVT 的髮生，值得臨床推廣應用。
목적탐토술중간헐성기낭가압법（intermittent pneumatic compression method，IPC）재부과복강경환자중적응용효과。방법장200례불잉증행복강탐사환자분위관찰조화대조조，매조각100례。량조균재전신마취화방광절석위하행복강경수술，술중대조조불채용임하간예조시，관찰조채용 IPC。비교량조환자술전、술후제1 d 화제3 d 응혈공능지표；술전、수술후30 min、술후제1 d 고정맥혈류속도；술후3개월심정맥혈전（deep vein thrombosis，DVT）발생솔적차이。결과술후3개월대조조발생 DVT 12례，관찰조2례，량조비교，χ2＝6.22，P＜0.05，차이구유통계학의의。관찰조환자술후제1 d 응혈매원시간（prothrombintime，PT）화응혈활매시간（activated par-tialthrom boplastin time，APTT）고우대조조，술후제1 d 화제3 d 섬유단백원（human fibrinogen，FIB）저우대조조（균 P＜0.05）。술후30 min 화술후24 h 관찰조환자고정맥혈류속도대우대조조，량조비교，차이구유통계학의의（균 P＜0.05）。관찰조각시간점고정맥혈류속도비교，F＝1.94，P＞0.05，차이무통계학의의。결론IPC 응용우복강경수술시안전유효적，능개선하지혈액순배화예방하지 DVT 적발생，치득림상추엄응용。
Objective To study the effect of intraoperative intermittent pneumatic compression(IPC)on patients undergoing gynaecological laparoscopic surgery.Methods Two hundred infertile patients to undergo exploratory laparotomy were randomized equally into the observation group and the control group.The patients in both groups were managed with laparoscopic operation at lithotomy position under general anaesthesia.During the operation,the control group was treated with nil intervention,while the observation group with IPC.The two groups were compared in terms of blood coagulation indexes before operation,days 1 and 3 after operation,blood flow rate of femoral vein before operation,30 mins and day 1 after the operation,and deep vein thrombosis(DVT) three months after operation.Results Three months after operation,12 cases of DVT occurred in the control group,and only 2 cases in the observation group.The difference was significant between the groups(χ2=6.22,P<0.05).The prothrombintime time and activated par-tialthrom boplastin time in the observation group were both longer than those of the control group,but the human fibrinogen was less(all P<0.05).The blood flow rate of femoral vein in the observation group was higher than that of the control group 30 mins and day 1 after operation(P<0.05),though the rates of femoral vein in the observation group showed insignificant differences between all the time points(F=1.94,P>0.05).Conclusion IPC used during laparoscopic surgery may be safe and effective as a result of improving blood circulation of lower limbs and preventing venothrombosis in lower limbs.
