Effects of intermittent pneumatic compression of the thigh on blood flow velocity in the femoral and popliteal veins: developing a new physical prophylaxis for deep vein thrombosis in patients with plaster-cast immobilization of the leg
Effects of intermittent pneumatic compression of the thigh on blood flow velocity in the femoral and popliteal veins: developing a new physical prophylaxis for deep vein thrombosis in patients with plaster-cast immobilization of the leg
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DOI：
10.1007/s11239-016-1403-y
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发表时间：
2016-11-01
影响因子：
4
通讯作者：
Kitagawa, Jun
中科院分区：
文献类型：
--
作者：
Nakanishi, Keisuke;Takahira, Naonobu;Kitagawa, Jun
下肢石膏固定的患者在没有预防的情况下估计静脉血栓栓塞率为2.5%，其中包括许多致命病例。然而，对于这些患者的深静脉血栓形成（DVT）没有实际的物理预防措施。本研究的目的是检查单独对大腿进行间歇性气动压迫（大腿IPC）对腿部峰值血流速度（PBV）的影响，并考虑大腿IPC可用于下肢石膏固定患者DVT的物理预防的可能性。招募了9名健康男性志愿者和18名老年男性。我们用石膏夹板固定每个受试者的右小腿和脚踝，并应用ActiveCare+S.F.T.（A（R））（Medical Compression Systems，Inc.）每个受试者的右大腿。应用双功多普勒超声测量股浅静脉（PBVFV）和腘静脉（PBVPV）的PBV。与仰卧位静息相比，老年组大腿IPC导致PBVFV增加2.3倍，PBVPV增加3.0倍。尽管大腿IPC也显著增加了坐位的PBVFV和PBVPV，但仰卧位和坐位的PBV变化率相同（PBVFV增加2.6倍，PBVPV增加2.9倍）。仰卧位和坐位大腿IPC显著增加PBVFV和PBVPV，并且可以有效预防下肢石膏固定患者的DVT。
Patients with plaster-cast immobilization of the lower limb have an estimated venous thromboembolism rate of 2.5 % without prophylaxis, which includes many fatal cases. However, there is no practical physical prophylaxis for deep-vein thrombosis (DVT) in these patients. The aim of this study was to examine the effects of intermittent pneumatic compression on the thigh alone (IPC to the thigh) on peak blood velocity (PBV) in the legs and to consider the possibility that IPC of the thigh could be used as physical prophylaxis for DVT in patients with plaster-cast immobilization of the lower leg. Nine healthy male volunteers and eighteen elderly males were recruited. We immobilized each subject's right lower leg and ankle with a plaster splint, and applied the ActiveCare+S.F.T.(A (R)) (Medical Compression Systems, Inc.) device to each subject's right thigh. The PBV in the superficial femoral vein (PBVFV) and the popliteal vein (PBVPV) were measured using duplex Doppler ultrasonography. IPC to the thigh resulted in a 2.3-fold increase in PBVFV and a 3.0-fold increase in PBVPV compared with resting at supine in the elderly group. Although IPC to the thigh also increased PBVFV and PBVPV significantly in the sitting position, the change ratios of PBV in the supine and sitting positions were equal (2.6-fold increase in PBVFV and 2.9-fold increase in PBVPV). IPC to the thigh in supine and sitting positions significantly increased PBVFV and PBVPV, and could be a useful prophylaxis for DVT in patients with plaster-cast immobilization of the lower leg.