间歇性气压压缩在预防迪克森手术期间深静脉血栓的应用领域:一个随机对照试验
Xiaotian Zhou1, Liqing Zhang2, Jinxia Cai1
1Department of Anesthesiology, First Affiliated Hospital, Wenzhou Medical University, Wenzhou.
Clinical therapeutics
|August 25, 2023
概括
间歇性气动压缩 (IPC) 在脚或小腿上有效地减少了腹腔镜手术后的第一天深静脉血栓 (DVT) 的患病率. 然而,在第7天后,益处没有持续,这表明局部压缩时间是预防DVT的关键.
科学领域:
- 血管外科 血管外科
- 进行血栓预防治疗.
- 医疗器械 医疗器械
背景情况:
- 深静脉血栓症 (DVT) 是腹腔镜手术后的一个严重并发症,特别是在石切位.
- 间歇性气压压缩 (IPC) 是预防DVT的标准方法,但最佳应用领域仍在研究中.
- 压缩袖位置对IPC对血栓预防的疗效的影响需要进一步澄清.
研究的目的:
- 为了比较不同间歇性气压压缩 (IPC) 应用区域在腹腔镜手术后预防深静脉血栓 (DVT) 的有效性.
- 为了调查IPC是否适用于脚,小腿或大腿,影响DVT患病率和静脉血液动力学.
- 评估IPC位置对与血栓形成相关的血液学指标的影响.
主要方法:
- 一项随机对照试验,涉及164名接受腹腔镜迪克森手术的患者.
- 患者被分为四组:脚,小腿,大腿的IPC,或对照组 (没有IPC).
- 深静脉血栓 (DVT) 在术后第1天和第7天使用超声波评估,测量血液速度,流量和常见的股骨静脉直径. 还进行了血液学分析.
主要成果:
- 在术后第一天,IPC应用于脚或小牛,与对照组相比,显著降低了DVT患病率 (P=0.024).
- 腿部的IPC在DVT预防方面没有显著的益处 (P=0.781).
- 脚和小腿的IPC增加了普通大腿静脉中的平均血液速度和血液流量,表明静脉回流有所改善. 然而,这些差异在术后第7天并不显著.
结论:
- 在术后第一天对脚或小腿施加间歇性气压 (IPC) 有效增强静脉回归并降低腹腔镜手术后深静脉血栓 (DVT) 风险.
- 在所有测试的压缩区域中,IPC对DVT患病率和血液学指标的预防作用在术后第7天没有持续.
- 结果表明,IPC应用的时间和位置是实现手术患者短期DVT预防的关键因素.
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