中凹卧位联合间歇充气加压泵预防胸腹腔镜食管癌根治术后深静脉血栓的效果

目的：探讨中凹卧位联合间歇充气加压泵预防胸腹腔镜食管癌根治术患者术后深静脉血栓(deep vein th-rombosis, DVT)的效果及影响。方法：行胸腹腔镜食管癌根治术104例患者随机分为常规护理组(对照组)和中凹卧位联合间歇加压充气泵组(观察组)，各52例。对照组采用常规护理措施，行腹部手术操作时采取常规体位，整体头高足低20°。观察组行腹部手术操作时采用中凹卧位(头胸部抬高20°，下肢抬高30°)联合间歇充气加压泵，术后连续3 d使用间歇充气加压泵。术后1周比较两组患者的DVT形成情况。通过比较两组患者的凝血功能及Caprini血栓风险评估DVT发生的风险。同时比较两组患者的护理满意度。结果：观察组患者的DVT发生率为1.9%，显著低于对照组(13.5%)(P=0.027)。观察组患者术后即刻，术后第1、3天的D-二聚体水平及Caprini血栓风险评分均低于对照组(均P＜0.05)。观察组的护理满意度显著高于对照组(P＜0.05)。结论：中凹卧位联合间歇充气加压泵可有效预防胸腹腔镜食管癌根治术患者术后DVT的发生，提高了护理满意度，值得推广应用。

Effect of concave position combined with intermittent inflatable pump on prevention of deep vein thrombosis after thoracoscopic laparoscopic radical resection for esophageal cancer*

Objective: To investigate the effect of concave position combined with intermittent inflatable pump on prevention of deep vein thrombosis(DVT) after thoracoscopic laparoscopic radical resection for esophageal cancer. Methods: A total of 104 patients who underwent thoracolaparoscopic radical resection of esophageal cancer were randomly divided into the routine nursing group(control group) and the concave position combined with intermittent inflatable pump group(experimental group).Each group included 50 cases. The patients in the control group were treated with routine nursing, and the abdominal operation was performed in a conventional position, with the overall head height and foot lower than 20°. Patients in the experimental group received abdominal surgery using a concave position(20° elevation of the head and chest, 30° elevation of the lower limbs) combined with intermittent inflatable pump, and the intermittent inflatable pump was used during the first three days after surgery. The incidence rate of DVT in the two groups was compared one week after surgery. The risk of DVT was assessed by comparing the coagulation function of patients in the two groups with the Caprini risk factor assessment table. Meanwhile, the nursing satisfaction of the two groups was compared. Results: The incidence of DVT in the experimental group was 1.9%, significantly lower than that in the control group(13.5%), the difference was statistically significant(P=0.027). The D-dimer level and Caprini thrombosis risk score of the experimental group were significantly lower than those of the control group immediately after surgery, on day 1 and day 3 after surgery(P<0.05). The nursing satisfaction of the experimental group was significantly higher than that of the control group(P<0.05). Conclusion: The concave position combined with intermittent inflatable pump can prevent the occurrence of DVT after the radical resection of thoracic and laparoscopic esophageal cancer effectively. It increases nursing satisfaction and is worth promoting and applying.