间歇充气加压装置不同使用时长对预防腰椎融合术中患者静脉血栓的效果评价

目的 探讨腰椎融合术术中间歇充气加压装置不同使用时长对深静脉血栓和血流动力学的影响.方法 采用便利抽样方法,选取2020年6月—2021年3月在郑州市某三级甲等医院脊柱外科择期行腰椎融合术患者61例,按照随机数字表法分为试验组和对照组.在给予常规护理的基础上,两组均于手术开始即刻启用间歇充气加压装置,均使用2次,且2次...

Intervention study of applying intermittent pneumatic compression devices with different duration in lumbar fusion surgery

Objective To investigate the effect of applying the intermittent pneumatic compression devices（IPCD）with different duration on hemodynamics of deep venous thrombosis（DVT） during lumbar fusion surgery. Methods Using the convenient sampling method,a total of 61 patients who received lumbar fusion surgery in the spinal surgery department of a tertiary A hospital in Zhengzhou from June 2020 to March in 2021 were randomly divided into an experimental group and a control group. On the basis of the routine nursing care,the patients in both groups started to use the IPCD immediately after the surgery. 2 groups both employed it twice with the interval time of 15 minutes. The duration of application was for 30 minutes in the control group and 40 minutes in the experimental group respectively. The incidence of DVT,coagulation indexes,hemodynamics and intraoperative blood loss were compared between the 2 groups. Results Finally,a total of 60 patients were included. There was no symptomatic deep venous thrombosis in the 2 groups,but 2 cases（6.7%） in the control group and 1 case（3.3%）in the experimental group had intramuscular venous thrombosis,with no statistical difference（ χ²=0.351,P=0.554）. The results of repeated measurement analysis of variance on patients’ coagulation indexes and hemodynamics showed that the time effect of fibrinogen and femoral vein peak velocity,the interaction between groups and time,and the grouping effect were statistically significant,respectively（F_time=222.466 and 45.899,P_time<0.001;F_interactive=12.707 and 4.873,P_interactive<0.001 and=0.009;F_{between groups}=10.052 and 43.975,P_{between groups}=0.002 and 0.008）. There was no significant difference in intraoperative blood loss between the 2 groups（t=0.189,P=0.851）. Conclusion The use of IPCD during lumbar fusion surgery for 40 minutes is much better than 30 minutes each time,for twice in total in promoting fibrinogen dissolution and accelerating the peak velocity of femoral vein blood. It can effectively improve the blood hypercoagulability and reduce the risk factors of intraoperative DVT.