Effect Of Intraoperative Physical Intervention On Prevention Of Deep Venous Thrombosis Of Lower Limbs In Patients With Digestive Tract Tumors

Objective:The purpose of this study was to observe whether different physical interventions(intermittent pneumatic pressure pump(IPC),gradient compression elastic socks(GCS)combined with intermittent pneumatic pressure pump(IPC)can effectively reduce the incidence of deep venous thrombosis(DVT)in lower extremities of patients undergoing gastrointestinal cancer surgery,and whether they can be used differently in patients undergoing gastrointestinal cancer surgery.The efficacy and safety of physical interventions to prevent DVT were preliminarily studied,and more effective physical interventions to prevent DVT in patients undergoing gastrointestinal cancer surgery were explored.Methods:From January 2018 to January 2019,100 patients with digestive tract tumors underwent operation in the operating room of Shanxi People's Hospital were randomly divided into two groups: group A: IPC group(50 cases);group B: GCS + IPC group(50cases).The two groups of patients were given basic nursing measures to prevent deep venous thrombosis during perioperative period.On the basis of basic nursing,IPC was used to strengthen the blood flow of deep veins in lower limbs in group A(IPC group),while GCS and IPC were used to prevent deep venous thrombosis in group B(GCS + IPC group).The hemodynamic changes of deep vein of lower extremity and related coagulation indexes were detected before and after operation in both groups.The effects of different physical interventions were evaluated by the occurrence of deep vein thrombosis after operation.Results:(1)The results of this observation showed that the incidence of DVT in group A was12%,and that in group B was 8%.There was no statistical difference in preventionbetween the two groups.(2)Hemodynamic comparison of lower extremity veins:(1)There was no significant difference in the diameter of lower extremity veins between groups A and B before and after operation;(2)There was significant difference in the velocity of lower extremity veins between groups A and B before and after operation;(3)There was significant difference in the velocity of external iliac vein,deep femoral vein and popliteal vein after operation between groups A and B,and the velocity of common femoral vein was different.The difference was not statistically significant.(3)Comparisons of coagulation indexes before and after operation: There was significant difference between group A and group B in D-dimer and FIB before and after operation,and there was no significant difference in APTT and PT;there was significant difference between group A and group B in coagulation indexes after operation;there was no significant difference between group A and group B in D-dimer and FIB after operation;there was no significant difference in APTT and PT.Conclusion:(1)Intraoperative use of IPC alone or combined use of GCS can effectively prevent the occurrence of DVT after digestive tract cancer surgery.(2)GCS combined with IPC alone can not significantly reduce the incidence of deep venous thrombosis in patients undergoing gastrointestinal cancer surgery.(3)The combined use of GCS can significantly improve the blood flow velocity of external iliac vein,deep femoral vein and popliteal vein,D-dimer and FIB indexes after digestive tract cancer surgery.