关键词: 剖宫产术, 间歇充气加压, 下肢静脉血栓症, 抗凝

Abstract:

Objective　To investigate the effect of intermittent pneumatic compression (IPC) combined with anticoagulants in the prevention of deep venous thrombosis of lower extremity in patients after cesarean section. Methods　Ninety-six pregnant women undergoing cesarean section in Yan'an City Hospital of Traditional Chinese Medicine from July 2021 to June 2022 were included in the study, and were divided into a combination group and an anticoagulation group according to the treatment plans, with 48 cases in each group. The combination group were (28.98±3.81) years old, and had delivered (0.98±0.23) times. The the anticoagulation group were (29.52±4.06) years old, and had delivered (1.04±0.29) times. The anticoagulation group subcutaneously injected low molecular weight heparin sodium after cesarean section; in addition, the combination group took IPC. The incidences of venous thrombosis of lower extremity, perioperative coagulation function [prothrombin time (PT), thrombin time (TT), D-dimer (D-D), and fibrinogen (FIB)], hemorheology indicators [plasma viscosity (PV), high shear viscosity (HBV) of whole blood, and erythrocyte deformity-index (EDI)], and surgery-related indicators (postoperative exhaust time, postoperative off-bed time, and lower limb pain) were compared between the two groups. t test, repeated measure analysis of variance, and Fisher exact probability method were used for statistical comparisons. Results　The incidence rate of venous thrombosis of lower extremity in the combination group was 0, and that in the anticoagulation group 4.17% (2/48), with no statistical difference (P=0.495). Five days after the surgery, the PT and TT were higher than those before the surgery in both groups, and the levels of D-D and FIB were lower; the PT, TT, and levels of D-D and FIB in the combination group were better than those in the anticoagulation group [(13.29±1.27) s vs. (12.67±1.62) s, (15.04±1.09) s vs. (14.38±1.17) s, (1.74±0.32) mg/L vs. (2.41±0.53) mg/L, and (4.39±0.51) g/L vs. (5.01±0.48) g/L], with statistical differences (all P<0.05). Five days after the surgery, the PV, HBV, and EDI were higher than those before the surgery in both groups; the PV and HBV in the combination group were lower than those in the anticoagualation group [(1.92±0.44) mPa/s vs. (2.17±0.51) mPa/s and (4.81±0.51) mPa/s vs. (5.12±0.57) mPa/s], and the EDI was higher (1.29±0.23 vs. 1.06±0.21), with statistical differences (all P<0.05). The postoperative exhaust time and off-bed time in the combination group were shorter than those in the anticoagulation group [(17.63±1.85) h vs. (20.17±1.73) h and (24.25±2.53) h vs. (31.88±2.46) h], and the score of Visual Analogue Scale was lower (1.27±0.45 vs. 2.08±0.28), with statistical differences (all P<0.05). Conclusion　PIC combined with anticoagulants can effectively improve the coagulation function and hemodynamics of parturients after cesarean section, effectively prevent the formation of deep venous thrombosis of lower extremity, and promote their recovery.

Key words: Caesarean section, Intermittent pneumatic compression, Deep venous thrombosis of lower extremity, Anticoagulation