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[间歇性充气加压对直肠癌切除术后下肢凝血功能及深静脉血流动力学的影响]

[Effect of intermittent pneumatic compression on coagulation function and deep venous hemodynamics of lower limbs after rectal cancer resection].

作者信息

Wang Jian-ping, Lin Yu-dong, Wang Lie, Xu Fang-gui, Gao Yuan, Li Cheng-jin, Xia Yin, Zhu Jian-Ping, Wu Zhong-Qiu

机构信息

Research Institute of General Surgery, Department of General Surgery, Fuzhou General Hospital of Nanjing Military Command, Fuzhou 350025, China.

出版信息

Zhonghua Wei Chang Wai Ke Za Zhi. 2013 Aug;16(8):739-43.

Abstract

OBJECTIVE

To investigate the effects of intermittent pneumatic compression (IPC) on coagulation function, deep venous hemodynamics and prevention of deep venous thrombosis (DVT) of lower limbs in patients after rectal cancer resection.

METHODS

A total of 120 patients undergoing rectal cancer resection were randomly divided into non-IPC group (control group, n=60) and IPC group (n=60). The control group received routine treatment after resection and the IPC group received IPC based on the routine treatments. Prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), international normalized ratio (INR) and volume of D-dimer (D-D) were detected before operation and 1-, 3-, 5- and 7-day after operation. Meanwhile, blood flow velocity and caliber of external iliac vein, femoral vein and popliteal vein were examined by color Doppler ultrasound, then the average blood flow velocity and blood flow volume were calculated.

RESULTS

Incidence of lower limb DVT was 13.3% (8/60) and 1.7% (1/60) in control group and IPC group respectively with significant difference (P<0.05). The differences in PT, APTT and INR were not significant (P>0.05) at 1-day after operation as compared to the preoperative level, while FIB and D-D both increased (P<0.05), all presented no significant difference among the two groups (P>0.05). PT shortened gradually (P<0.05), APTT and INR did not change significantly (P>0.05), FIB and D-D increased gradually (P<0.05), and no significant differences were found between the two groups at the same time point (all P>0.05). All the above parameters in the control group were significantly lower than those in IPC group (all P<0.05).

CONCLUSIONS

IPC can improve hemodynamics indexes of deep veins of lower limb in patients after rectal cancer operation, and prevent the lower limb DVT. IPC is a safe, simple and convenient physical therapy.

摘要

目的

探讨间歇性充气加压(IPC)对直肠癌切除术后患者凝血功能、下肢深静脉血流动力学及预防下肢深静脉血栓形成(DVT)的影响。

方法

将120例行直肠癌切除术的患者随机分为非IPC组(对照组,n = 60)和IPC组(n = 60)。对照组术后接受常规治疗,IPC组在常规治疗基础上接受IPC治疗。于术前及术后1、3、5、7天检测凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、国际标准化比值(INR)及D-二聚体(D-D)含量。同时,采用彩色多普勒超声检测髂外静脉、股静脉及腘静脉的血流速度及管径,计算平均血流速度及血流量。

结果

对照组下肢DVT发生率为13.3%(8/60),IPC组为1.7%(1/60),差异有统计学意义(P<0.05)。术后1天,两组PT、APTT及INR与术前比较差异无统计学意义(P>0.05),而FIB及D-D均升高(P<0.05),两组间比较差异无统计学意义(P>0.05)。术后PT逐渐缩短(P<0.05),APTT及INR无明显变化(P>0.05),FIB及D-D逐渐升高(P<0.05),同一时间点两组间比较差异无统计学意义(均P>0.05)。对照组上述各指标均显著低于IPC组(均P<0.05)。

结论

IPC可改善直肠癌术后患者下肢深静脉血流动力学指标,预防下肢DVT。IPC是一种安全、简便、易行的物理治疗方法。

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