| 孙惠华.倾向性评分匹配比较不同气腹模式对腹腔镜结直肠癌手术患者下肢深静脉血流速度的影响[J].上海护理,2025,25(2): |
| 倾向性评分匹配比较不同气腹模式对腹腔镜结直肠癌手术患者下肢深静脉血流速度的影响 |
| Effect of different pneumoperitoneum modes on lower extremity deep venous blood flow velocity in patients undergoing laparoscopic surgery :a propensity score matching analysis |
| DOI： |
| 中文关键词: CO2气腹 腹腔镜手术 血流速度 深静脉血栓 |
| 英文关键词:CO2 pneumoperitoneum Laparoscopic surgery Blood flow velocity Deep venous thrombosis |
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| 中文摘要: |
| 【】目的:探讨CO2气腹模式对腹腔镜结直肠癌手术患者下肢深静脉血流速度的影响。方法:根据便利抽样法选择2020年6月～2023年2月于上海某三级综合性医院腹腔镜直肠癌及乙状结肠癌手术患者共606例, 对照组(传统气腹组)490例,观察组(稳压气腹组)116例,通过倾向性评分匹配(PSM),对匹配成功的111对腹腔镜直肠癌及乙状结肠癌手术患者术中60min下肢深静脉血流速度变化、术后深静脉血栓发生情况及凝血功能指标进行对比分析。结果:通过倾向性评分匹配成功的111对腹腔镜直肠癌及乙状结肠癌手术患者的研究中,发现气腹60min及气腹解除后稳压气腹较传统气腹模式对血流速度的影响小,PSV及EDV均有统计学差异(P<0.05)；两组患者凝血系统均明显被激活,PT、APTT均缩短,术后D‐D水平明显升高(P<0.001),两组患者术后DVT发生率比较,差异无统计学意义(P>0.05)。结论:CO2气腹可致腹腔镜结直肠癌手术患者下肢深静脉血流速度下降,稳压气腹组较传统气腹组影响小,推荐稳压气腹可在临床工作中使用。 |
| 英文摘要: |
| Objective: To investigate the correlation between the different modes of CO2 pneumoperitoneum laparoscopic surgery patients with femoral vein of lower limb blood flow and the application effect evaluation. METHODS: According to the convenience sampling method, a total of 606 colorectal cancer patients undergoing laparoscopic surgery in a general hospital from June 2020 to February 2023 were selected,including 490 patients in the control group (traditional pneumoperitoneum group) and 116 patients in the observation group (stabilized pneumoperitoneum group). Propensity score matching analysis between stabilized pneumoperitoneum and traditional pneumoperitoneum was performed．To compare the blood flow velocity of lower extremity deep vein and the occurrence of postoperative DVT、blood coagulation function test. RESULTS: 111 pairs of laparoscopic rectal cancer and sigmoid cancer surgery patients were successfully matched by propensity score. There were impact on blood flow velocity of stabilized pneumoperitoneum compared with traditional pneumoperitoneum mode, expecially at 60min and after pneumoperitoneum release .The PSV and EDV had statistical differences (P<0.05).There were statistically significant differences in activated partial thrombin time (APTT), prothrombin time (PT) and D? dimer (D?D) values between the two groups at 24h postoperatively and in the preoperative group (P<0.01). CONCLUSIONS: CO2 pneumoperitoneum can decrease the blood flow velocity of lower extremity deep vein in patients undergoing laparoscopic colorectal cancer surgery, and the effect of stabilized pneumoperitoneum mode is less than that of traditional pneumoperitoneum . Stabilized pneumoperitoneum can be safely used in clinical work. |
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