慢性静脉功能不全患者应用新型ipc改善血流动力学的效果.docVIP

慢性静脉功能不全患者应用新型IPC改善血流动力学的效果及相关临床研究 Improved hemodynamic effectiveness and associated clinical correlations of a new intermittent pneumatic compression system in patients with chronic venous insufficiency Stavros K. Kakkos, MD, MSc, Gabriel Szendro, MD, FRCS,a Maura Griffin, DCR, DMU, MSc,Michael M. Sabetai, MD, and Andrew N. Nicolaides, MD, MS, FRCS, London, United Kingdom Purpose: A new intermittent pneumatic compression device (SCD Response System) has recently been shown in healthy volunteers to have the ability to detect the post-compression refilling of the calf veins and to respond by initiating the subsequent cycle when these veins are full. This has proven to be more effective in expelling blood proximally than the conventional intermittent pneumatic compression device (SCD Sequel System). The aim of this study was to test the influence of venous disease on the post-compression refill time detected by means of the SCD Response and the effectiveness of the new system in expelling blood in patients who have venous reflux caused by post-thrombotic syndrome or varicose veins. Methods: This open, controlled trial was conducted in an academic vascular unit with 10 patients who had post-thrombotic syndrome and 10 patients who had varicose veins. The new SCD Response System was tested against the existing SCD Sequel System in both legs in the supine, semirecumbent, and sitting positions. The refilling time sensed by means of the device was correlated with the venous filling index by using air plethysmography. The total volume of blood expelled per hour during compression was compared with that expelled by the SCD Sequel System in the same volunteers and in the same positions. Results: An inverse association was found between the mean postcompression refilling time in the sitting position and the venous filling index of the apparently healthy or less severely affected leg (r = -0.52, P = .019), the refill time being significantly shorter in patients with advanced v