切换至 "中华医学电子期刊资源库"

中华消化病与影像杂志(电子版) ›› 2019, Vol. 09 ›› Issue (06) : 263 -266. doi: 10.3877/cma.j.issn.2095-2015.2019.06.006

所属专题: 文献

临床研究

间歇式充气加压泵对腹腔镜直肠癌患者下肢深静脉血流变化的影响
周亚芬1, 胡文娟1,(), 黄一乐1, 姜建平1, 黄鑫1, 陈国立1, 邱江锋1   
  1. 1. 200127 上海交通大学医学院附属仁济医院东院手术室
  • 收稿日期:2019-09-14 出版日期:2019-12-01
  • 通信作者: 胡文娟
  • 基金资助:
    上海交通大学医学院科技基金项目(Jyhz1702)

Effects of intermittent pneumatic compression on blood flow of deep veins in lower limbs in rectal cancer patients with laparoscopic surgery

Yafen Zhou1, Wenjuan Hu1,(), Yile Huang1, Jianping Jiang1, Xin Huang1, Guoli Chen1, Jingfeng Qiu1   

  1. 1. Operating Theater, Eastern Branch of Renji Hospital Affiliated to Medical School of Shanghai Jiaotong University, Shanghai 200127, China
  • Received:2019-09-14 Published:2019-12-01
  • Corresponding author: Wenjuan Hu
  • About author:
    Corresponding author: Hu Wenjuan, Email:
引用本文:

周亚芬, 胡文娟, 黄一乐, 姜建平, 黄鑫, 陈国立, 邱江锋. 间歇式充气加压泵对腹腔镜直肠癌患者下肢深静脉血流变化的影响[J/OL]. 中华消化病与影像杂志(电子版), 2019, 09(06): 263-266.

Yafen Zhou, Wenjuan Hu, Yile Huang, Jianping Jiang, Xin Huang, Guoli Chen, Jingfeng Qiu. Effects of intermittent pneumatic compression on blood flow of deep veins in lower limbs in rectal cancer patients with laparoscopic surgery[J/OL]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2019, 09(06): 263-266.

目的

探讨间歇式充气加压泵对腹腔镜直肠癌根治术患者术中下肢深静脉血流的影响效果。

方法

选取2017年9月至2019年2月在上海交通大学医学院附属仁济医院东院接受腹腔镜直肠癌根治手术患者82例,随机分为试验组36例和对照组46例。对照组采用常规护理,试验组术中采用间歇式充气加压泵。2组均在截石位摆放前及手术结束双下肢复位前采用彩色多普勒超声诊断设备检测股静脉血管内径(mm)、最大血流速度(cm/s)及血流量(ml/s),比较分析2组患者临床资料与术前术后下肢静脉血流动力学变化的相关关系。

结果

2组患者在术前术后股静脉流速、流量及管径差值的血流动力学变化比较,差异均有统计学意义(P<0.01)。

结论

应用间歇式充气加压泵后能有效改善腹腔镜直肠癌根治患者围手术期下肢静脉的血液流变学变化,改善血液循环。通过血流动力学监测,为预防腔镜直肠癌根治患者术后下肢深静脉血栓的发生提供理论依据。

Objective

To investigate the effects of intermittent pneumatic compression(IPC)on blood flow of deep veins in lower limbs in patients after laparoscopic radical resection of rectal cancer.

Methods

A total of 82 patients undergoing laparoscopic radical resection of rectal cancer were selected from September 2017 to February 2019 in Eastern Branch of Renji Hospital Affiliated to Medical School of Shanghai Jiaotong University, and the patients were randomly divided into experimental group(36 cases)and control group(46 cases). The control group received routine treatment, while the experimental group was treated with IPC during operation.The diameter(mm), the maximum blood flow velocity(cm/s)and blood flow(ml/s)of femoral vein were measured by color Doppler ultrasonography before placement of lithotomy position during operation and before lower limbs were laid down at the end of operation in both groups.The correlations between the hemodynamic change in femoral vein before and after operation and the clinical data of the two groups were compared and analyzed.

Results

There were significant differences in the changes before and after operation of velocity, flow and diameter of femoral vein between the two groups(P<0.01).

Conclusion

IPC can effectively improve the hemodynamic indexes of deep veins of lower limbs and blood circulation in patients undergoing laparoscopic radical rectal cancer.It is effective to prevent the occurrence of deep venous thrombosis of lower limbs after operation.

表1 2组患者术前一般情况比较(±s)
表2 2组患者血流动力学变化比较(±s)
1
Longo D, Fauci A, Kasper D,et al.Harrison′s manual of medicine[M].18th ed.New York:McGraw Hill Professional,2012.
2
Geerts WH, Bergqvist D, Pineo GF,et al.Prevention of venous thromboembolism:Ameri癌n College of Chest Physicians Evidence-Based Clinical Practice Guidelines(8th Edition)[J].Chest,2008,133(6):381S-453S.
3
朴玉粉,徐翔,金三丽.腹盆部肿瘤患者围术期深静脉血栓形成预防的研究进展[J].中华现代护理杂志,2018,24(30):3603-3608.
4
陈晶,包文,白山,等.LC术中气腹压对下肢静脉压的影响研究[J].当代医学,2011,17(29):43-45.
5
刘萍,雷震,杨丽琴,等.妇科腹腔镜术中使用周期性充气压力泵预防深静脉血栓的观察[J].护理学报,2012,19(1A):53-55.
6
Nitta D, Mitani H, Ishimura R,et al.Deep vein thrombosis risk strafication[J].Int Heart J,2013,54(3):166-170.
7
彭晓燕,王可可,何亮.妇科腹腔镜手术后深静脉的护理[J].实用临床医药杂志,2013,17(18):161-162.
8
韩喆.腹腔镜手术并发深静脉血栓患者预防肺栓塞发生的个性化护理体会[J].腹腔镜外科杂志,2012(3):188-191.
9
Gould MK, Garcia DA, Wren SM.Prevention of VTE in nonor thopedic surgical patients:antithrombotic therapy and prevention of thrombosis:American College of Chest Physicians Evidence-Based Clinical Practice Guidelines(9th Edition)[J].Chest,2012,141(2):e227S-e277S.
10
艾宇航.围手术期患者下肢深静脉血栓的预防及治疗对策[J].中国实用外科杂志,2012,32(11):912-913.
11
马玉芬,郭一峰,陈亚萍,等.深静脉血栓高危风险患者物理预防的研究进展[J].中华现代护理杂志,2018,24(29):3473-3478.
12
马红滔,梁章焱,梁思重,等.腹腔镜术后下肢深静脉血栓形成危险因素的临床分析[J].中国现代普通外科进展,2016,19(1):66-68.
13
董咏梅,张若,陈聪,等.间歇充气装置辅助预防下肢深静脉血栓形成的疗效观察与护理[J].护士进修杂志,2008,23(12):1092-1093.
14
黄一乐,胡文娟,陈哲颖,周亚芬.间歇式充气加压仪在预防围术期深静脉血栓中的应用[J].护理研究,2013,27(5):1374-1375.
15
辛艳芬,蒲英梅,陈玉祥等.不同影像检查在下肢深静脉瓣膜功能不全临床诊断中价值[J].临床军医杂志,2018,46(12):1429-1431.
16
Meissner MH, Moneta G, Burnand K,et al.The hemodynamics and diagnosis of venous disease[J].J Vasc Surg,2007,46 Suppl S:4S-24S.
17
Nicolaides AN.Investigation of chronic venous insufficiency:a consensus statement[J].Circulation,2000,102:e126-163.
18
Eiberg JP, Grønvall Rasmussen JB,et al.Duplex ultrasound scanning of peripheral arterial disease of the lower limb[J].Eur J Vasc Endovasc Surg,2010,40(4):507-512.
[1] 赵丽霞, 王春霞, 陈一锋, 胡东平, 张维胜, 王涛, 张洪来. 内脏型肥胖对腹腔镜直肠癌根治术后早期并发症的影响[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 35-39.
[2] 吴晖, 佴永军, 施雪松, 魏晓为. 两种解剖入路下行直肠癌侧方淋巴结清扫的效果比较[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 40-43.
[3] 周世振, 朱兴亚, 袁庆港, 刘理想, 王凯, 缪骥, 丁超, 汪灏, 管文贤. 吲哚菁绿荧光成像技术在腹腔镜直肠癌侧方淋巴结清扫中的应用效果分析[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 44-47.
[4] 徐逸男. 不同术式治疗梗阻性左半结直肠癌的疗效观察[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 72-75.
[5] 李代勤, 刘佩杰. 动态增强磁共振评估中晚期低位直肠癌同步放化疗后疗效及预后的价值[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 100-103.
[6] 庄宝雄, 邓海军. 单孔+1腹腔镜直肠癌侧方淋巴结清扫术[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 601-601.
[7] 郑民华, 蒋天宇, 赵轩, 马君俊. 中国腹腔镜直肠癌根治术30年发展历程与未来[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 591-595.
[8] 池畔, 黄胜辉. 中国腹腔镜直肠癌根治术30年来的巨大进步[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 596-600.
[9] 李明, 屠松, 闫鹏, 钱军, 高鹏程, 许文山, 杨发英, 胡振涛, 单永玮. 应用前列腺电切镜引导置管治疗直肠低位吻合口漏研究[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 603-606.
[10] 李玲, 刘亚, 李培玲, 张秀敏, 李萍. 直肠癌患者术后肠道菌群的变化与抑郁症相关性研究[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 607-610.
[11] 严虹霞, 王晓娟, 张毅勋. 2 型糖尿病对结直肠癌患者肿瘤标记物、临床病理及预后的影响[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(06): 483-487.
[12] 赵磊, 刘文志, 林峰, 于剑, 孙铭骏, 崔佑刚, 张旭, 衣宇鹏, 于宝胜, 冯宁. 深部热疗在改善结直肠癌术后辅助化疗副反应及生活质量中的作用研究[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(06): 488-493.
[13] 陈杰, 武明胜, 李一金, 李虎, 向源楚, 荣新奇, 彭健. 低位直肠癌冷冻治疗临床初步分析[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(06): 494-498.
[14] 黄海洋, 邝永龙, 陈嘉胜. 基层医院结直肠肿瘤经自然腔道取标本手术30 例分析[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(06): 510-518.
[15] 王灿, 樊昊, 张卫, 于冠宇. LARS 评分的研制回顾与应用现状[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(06): 519-523.
阅读次数
全文


摘要