IPC预防妇科肿瘤术后静脉血栓.doc

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IPC预防妇科肿瘤术后静脉血栓 Prevention of Postoperative Venous Thromboembolism by External Pneumatic Calf Compression in Patients With Gynecologic Malignancy DANIEL L. CLARKE-PEARSON, MD, INGRID S. SYNAN, RN, WANDA M. HINSHAW, MS, R. EDWARD COLEMAN, MD, AND WILLIAM T. CREASMAN, MD One hundred seven patients undergoing major surgery for gynecologic malignancy participated in a controlled trial evaluating the effectiveness of pneumatic calf compression in the prevention of postoperative deep venous thrombosis and pulmonary embolism. External pneumatic calf compression was applied intraoperatively and for five postoperative days. All patients were prospectively screened for deep venous thrombosis with impedance plethysmography and 125 I-fibrinogen leg counting. Deep venous thrombosis and/or pulmonary emboli were detected in 18 of 52 control group patients (34.6%) whereas in seven of 55 (12.7%) of those treated with external pneumatic calf compression (P .005).External pneumatic calf compression was most effective during the first five days postoperatively and also reduced the incidence of deep venous thrombosis in patients at highest risk. When applied during surgery and for five days postoperatively, external pneumatic calf compression significantly reduces the incidence of postoperative venous thrombosis. (Obstet Gynecol 63:92, 1984) The prevention of pulmonary emboli and deep venous thrombosis must be an important effort of the pelvic surgeon caring for the high-risk group of patients who have pelvic malignancies. Over the past decade investigators have found low-dose heparin to prevent fatal pulmonary emboli 1 and 125 I-fibrinogen-detected leg thrombi.2-4 These studies have led to a general recommendation of low-dose heparin prophylaxis for high-risk groups.5 Low-dose heparin has been found to be ineffective in preventing venous thrombosis and pulmonary emboli after major surgery for gynecologic malignancies?6.7 Another prophylactic method, external pneumatic calf comp

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