Effect of comprehensive intraoperative physical intervention on preventing deep vein thrombosis of lower extremity in patients undergoing gynecological tumor surgery
10.3760/cma.j.cn115682-20210303-00954
- VernacularTitle:术中综合物理干预预防妇科肿瘤手术患者下肢深静脉血栓的效果
- Author:
Wenhui GAO
1
;
Jinghua DAI
;
Chunmei WU
;
Juanjuan ZHAI
;
Jianfeng WEI
Author Information
1. 山西省人民医院麻醉手术科，太原 030012
- Keywords:
Venous thrombosis;
Physical prevention;
Gynecologic surgical procedures;
Intermittent pneumatic compression device;
Graduated compression stockings
- From:
Chinese Journal of Modern Nursing
2022;28(2):209-214
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effect of comprehensive intraoperative physical intervention to prevent deep vein thrombosis (DVT) of lower extremity in patients with gynecological tumor surgery.Methods:From January 2020 to January 2021, 80 gynecological tumor patients undergoing surgery in Shanxi Provincial People 's Hospital were selected by convenience sampling as the research object. According to the random number table method, the patients were divided into the control group and the intervention group, each with 40 cases. The intervention group used intermittent pneumatic compression device (IPC) combined with graduated compression stockings (GCS) during the operation. In the control group, IPC was used alone for intervention. This study compared the blood flow rate and tube diameter of the lower extremity veins (common femoral vein, deep femoral vein, popliteal vein, and intermuscular vein) , blood coagulation indexes [prothrombin time (PT) , thrombin time (TT) , activated partial thromboplastin time (APTT) , fibrinogen (FIB) and D-dimer]before and after operation and the incidence of lower extremity DVT on the third day after operation between the two groups. Pearson correlation analysis was used to analyze the correlation between postoperative D-dimer and lower extremity venous blood flow rate. Results:There was no significant difference between the two groups of patients in the preoperative lower extremity venous blood flow velocity and diameter ( P>0.05) . The comparison of postoperative lower extremity venous blood flow rate between the two groups were statistically significant ( t=2.217, 4.863, 2.946, 2.397; P<0.05) . The diameters of common femoral vein, deep femoral vein and intermuscular vein between the two groups were statistically different ( t=2.117, 2.756, 2.274; P<0.05) , and there was no significant difference in the diameter of popliteal vein ( P>0.05) . There was no significant difference in PT, TT, APTT, FIB, D-dimer between the two groups of patients before operation ( P>0.05) . The differences in FIB and D-dimer between the two groups of patients were statistically significant ( t=-2.338, -3.554; P<0.05) . The incidence of lower extremity DVT in the intervention group was 2.5% (1/40) on the third day after operation, and the incidence of lower extremity DVT in the control group was 20.0% (8/40) , and the difference was statistically significant (χ 2=6.135, P<0.05) . Pearson correlation analysis showed that postoperative D-dimer and lower extremity venous blood flow rate were negatively correlated ( r=-0.484, -0.442, -0.358, -0.308; P<0.01) . Conclusions:The application of comprehensive intraoperative physical intervention of IPC combined with GCS can reduce the incidence of DVT in the lower extremities of patients with gynecological tumors, and it is worthy of clinical application.
