摘要
目的 探讨全身麻醉下腹腔镜全子宫切除术患者术后发生下肢深静脉血栓的危险因素。方法 收集2021年5月至2022年6月于亳州市人民医院进行腹腔镜下全子宫切除术的198例患者的临床资料,术后均进行下肢超声检查,根据下肢深静脉血栓的发生情况将患者分为发生组(n=10)和未发生组(n=188)。分析全身麻醉下腹腔镜全子宫切除术患者术后发生下肢深静脉血栓的危险因素。结果 单因素分析结果显示,发生组患者的糖尿病比例、未进行术后物理抗凝治疗的比例、未进行腹横肌平面阻滞的比例、D-二聚体水平、血小板计数均高于未发生组患者,术后卧床时间长于未发生组患者,差异均有统计学意义(P﹤0.05)。多因素分析结果显示,D-二聚体水平高、血小板计数高、合并糖尿病、未进行术后物理抗凝治疗、术后卧床时间长、未进行腹横肌平面阻滞均为腹腔镜下全子宫切除术患者术后发生下肢深静脉血栓的独立危险因素(P﹤0.05)。结论 全身麻醉下腹腔镜全子宫切除术患者术后下肢深静脉血栓的发生率较高,受多种因素的影响。全身麻醉复合腹横肌平面阻滞能够降低术后下肢深静脉血栓的发生率,促进患者术后康复。
Objective To investigate the risk factors for postoperative lower extremity deep vein thrombosis in patients undergoing laparoscopic hysterectomy under general anesthesia.Method The clinical data of 198 patients who underwent laparoscopic total hysterectomy at the People's Hospital of Bozhou from May 2021 to June 2022 were collected.Ultrasound examination of the lower extremity was performed after the surgery,and the patients were divided into occurrence group(n=10)and non-occurrence group(n=188)according to the occurrence of the lower extremity deep vein thrombosis.The risk factors for postoperative lower extremity deep vein thrombosis in patients undergoing laparoscopic hysterectomy under general anesthesia were analyzed.Result The results of univariate analysis showed that the proportion of patients with diabetes,the proportion of patients who did not undergo postoperative physical anticoagulation therapy,the proportion of patients who did not undergo transversus abdominis plane block,D-dimer levels, and platelet count in the occurrence group were all higher than those in the non-occurrence group, and the postoperative bed rest time was longer than that of the non-incidence group, and the differences were statistically significant (P﹤0.05). The results of multivariate analysis showed that high D-dimer levels, high platelet count, combined with diabetes, no postoperative physical anticoagulation therapy, long postoperative bed rest time, and no transversus abdominis plane block were all independent risk factors for the lower extremity postoperative deep vein thrombosis in patients undergoing laparoscopic hysterectomy under general anesthesia (P﹤0.05). Conclusion The incidence of the lower extremity postoperative deep venous thrombosis in patients undergoing laparoscopic hysterectomy under general anesthesia is high and related to multiple factors. General anesthesia combined with transversus abdominis plane block could reduce the incidence of postoperative lower extremity deep vein thrombosis and promote re
作者
梁珊珊
杨露
孟雨
金传名
董训忠
Liang Shanshan;Yang Lu;Meng Yu;Jin Chuanming;Dong Xunzhong(Department of Anesthesiology,the People's Hospital of Bozhou,Bozhou 236800,Anhui,China;Department of Vascular Surgery,the People's Hospital of Bozhou,Bozhou 236800,Anhui,China)
出处
《血管与腔内血管外科杂志》
2023年第10期1246-1249,1259,共5页
Journal of Vascular and Endovascular Surgery
基金
安徽理工大学校级资助项目(QN2019136)
亳州市卫生健康科研项目(bzwj2022a002)。
关键词
全身麻醉
腹腔镜全子宫切除术
下肢深静脉血栓
影响因素
general anesthesia
laparoscopic total hysterectomy
lower extremity deep vein thrombosis
risk factor
