IPC 预防术后静脉淤滞与DVT Intermittent sequential pneumatic compression of the legs in the prevention of venous stasis and postoperative deep venous hellip;.docVIP

IPC预防术后静脉淤滞与DVT Intermittent sequential pneumatic compression of the legs in the prevention of venous stasis and postoperative deep venous thrombosis N. Nicolaides, M.S., F.R.C.S., F.R.C.S.E., J. Fernandes e Fernandes, M.D., and A. V. Pollock, F.R.C.S., London and Scarborough, England The optimal stimulus which produced the maximum increase in blood velocity in the femoral vein during compression of the tower limb with a sequential compression device (six chambers) was determined using Doppler ultrasound in 10 normal limbs. Pressures of 35, 30, and 20 mm Hg at the ankle, calf, and thigh, respectively, applied sequentially for 12 seconds produced a 240% increase in the peak blood velocity. Higher pressures did not increase velocity any further. A nonsequential device (one chamber) inflated at 35 mm Hg for 12 seconds produced only a 180% increase in blood velocity. The efficacy of the sequential device to prevent deep venous thrombosis then was tested and compared with a single chamber device and small-dose subcutaneous heparin in a randomized, controlled clinical trial using the 125 l-fibrinogen test. The results suggest that the sequential compression device is as effective as heparin during the period when it is used (the first 24 hours after operation) and more effective than a nonsequential device in preventing deep venous thrombosis proximal to the calf. From the Academic Surgical Unit, Vascular Laboratory, St. Marys Hospital Medical School, London, and the Department of Surgery, Scarborough Hospital, Scarborough, England THE INCIDENCE of postoperative deep venous thromtx)sis can be reduced either by methods which prevent the hypercoagulable State which occurs after tissue trauma or by methods which prevent venous stasis.9 Although the former are effective, they carry a small but definite risk.8 Morbidity has not been demonstrated with intermittent pneumatic compression of the legs, which has reduced the incidence of deep venous thrombosis by 60% to 82% in three