| Objective:At present, there is no treatment standard of the way to preventing the deep vein thrombosis post-traumatic. It is because of no convincing evidence.We have to look for more effective methods to prevent DVT. It is necessary to search for effective approaches to prevent deep vein thrombosis after hysterectomy.It is complication to treat deep venous thrombosis. The risk exists at any time. Its'treatment time is longer. So we take methods to prevent DVT during the period of operation becomes more important. Up to now, the effects of chemical mathods such as taking small dose of low molecular weight heparin has been affirmed. But the complications are also co-exist in itself, such as bleeding, hematoma. Therefore non-invasive physical methods of prevention have been of concerned. However, there is little information about the effects and clinical applications of the prevention of deep venous thrombosis. In this study, gynecological benign and maligant patients were divided into two grous: IPCS Group and artificial massage Group. Then I did the clinical control study. According to the results of color Doppler, I formulated the efficacy standards. At last observated the clinical effects of IPCS in the prevention of DVT after gynecological hysterectomy.Methods:In the research, the patients from gynecological of China-Japan Hospital of Jilin University from January to October in 2008.They all undergone hysterectomy. They included 63 cases of patients with maligant tumors,65cases of benign tumor patients. I selected 63 patients with maligant tumor after hysterectomy randomly. Then divided them into Groups A and B,31 case of GroupA, Group B 32 cases; I selected 65 patients with benign tumor after hysterectomy randomly. Then divided them into Groups C and D,32cases of Group C and Group D with 33cases.For Group A and Group C,I did health guidance during the period of the operation to the patients and their family. At the same time, gave a botom-up massage of the gastrocnemins and soleus muscle of lower limb to the patients and let them active the ankle joint. For B and D Groups, I not only use the ways A and C Groups has been used but also use the intermittent pneumatic compression systems.Health guidence, manual massage methods include the following aspects: before the patients recoveried from the anesthesia, let their family help the nursing staff to turn over the patients'body once every two hours, therby improving the compression of the limb blood circulation; Give passive movement to the lower limb of the patients, the tautness of the muscle of the limb activity, benefit venous blood. After the patients recoveried from anesthesia, encourage patients have deep breath after a sober,12-15 times per hour in order to increase the transverse septum exercise, reducing the pleural pressure, promote blood circulation; Encourage the patients to do autonomy lower limb exercise. Encourage the patients take the initiative planter flexion and extention of the lower limbs include inverted movement, ankle'switah movement. For the elderly patients, guide the family members to help nurses to do passive bottom-up massage of lower limb soleus and gastrocnemius. Pay attention to keeping warm after operation, so that the vein not spasm. Encorage the patients to get out of bed early and do exercises. The patients can sit on the bed 24 hours after hysterectomy and do activity to both lower extremities. The patients can get out of bed 48 hours after operation, but tell them move slowly and gradually.The ways of Intermittent pneumatic compression systems when patients go back to wards after hysterectomy, they use the intermittent pneumatic compression system for preventive teatment. Then the frequency is 2 times one day , one time is for 2 hours. Both Lower limbs use that systerm at the same time for 2 days. The IPCS used in experiment, Its'manufacture is: Tyco Medical Equipment International trading(Shanghai)Co.Ltd, product name is KENDALL Series SCD stress antithrombotic pump, Product Specification Model is SCD EXPRESS tress system includes three components: mainframe, independent connection tubes, disposable sets of legs. Legs sets models include straight, gradient, circumferential stress mode,45mmHg to ankle,40mmHg to the calf,30mmHg to the thigh.SCD EXPRESS intermittent pneumatic compress devices of the intravenous. It can develop the operating parameters for each individual patient. The system detect the filling time of venous every 30 minutes and ajust the treatment parameters.Results:1. 128 cases of samples, the control group have happended five cases of lower extremity deep venous thrombosis, the experimental group there were no deep venous thrombosis. The efficacy results of the two prevention methods did Ridit rank test there was a significant difference (P<0.05) .2. The patients with maligant tumor in Gynecologic four patients have venous thrombosis in Group A. In Group B there is no patients with DVT. The efficacy results of the ways used in the prevention of deep venous thrombosis do Ridit rank sum test there was a significant difference (P<0.05) .3. The patients with benign tumor in Gynecologic one patient has venous thrombosis in Group C. In Group D, there is no patients with DVT. The efficacy results of the ways used in the prevention of deep venous thrombosis do Ridit rank sum test there was a significant difference (P<0.05) . 4. In this experiment the patients with benign and compared the incidence, there is no difference (P>0.05).Conclusion:1. In Gynecologic ,the patients with benign and maligant tumors need to prevent DVT. The ways of susing health guidence, artificial massage, IPCS. The efficacy results are higher than the clinical effects of health guidence, artificial massage ways.2. IPCS have priorities of massage intensity, strong and range. It has a significant role. The system detected the venous filling time automatically every 30 minutes and ajust the treatment parameters. Every patient take their own individual treatment programs. IPCS is an effective physical therapy to prevent DVT.
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