Agu O, Hamilton G, Baker D
University Department of Surgery, Royal Free Hospital, London NW3 2QP, UK.
Br J Surg. 1999 Aug;86(8):992-1004. doi: 10.1046/j.1365-2168.1999.01195.x.
Surveys still show a wide variation in routine use of deep vein thrombosis (DVT) prophylaxis despite its established place in current patient management. This article reviews the mechanism of action, efficacy and complications of stockings in preventing DVT.
Relevant publications indexed in Medline (1966-1998) and the Cochrane database were identified. Appropriate articles identified from the reference lists of the above searches were also selected and reviewed.
Graduated compression stockings reduce the overall cross-sectional area of the limb, increase the linear velocity of venous flow, reduce venous wall distension and improve valvular function. Fifteen randomized controlled trials of graduated compression stockings alone were reviewed. Stockings reduced the relative risk of DVT by 64 per cent in general surgical patients and 57 per cent following total hip replacement. The effect of stockings was enhanced by combination with pharmacological agents such as heparin; the combination is recommended in patients at moderate or high risk of DVT. Knee-length stockings are as effective and should replace above-knee stockings. Complications are rare and avoidable.
尽管深静脉血栓形成（DVT）预防措施在当前患者管理中已有明确地位，但调查显示其常规使用仍存在很大差异。本文综述了弹力袜预防DVT的作用机制、疗效及并发症。
检索Medline（1966 - 1998年）和Cochrane数据库中相关出版物。从上述检索的参考文献列表中筛选并审阅合适的文章。
梯度压力弹力袜可减小肢体的整体横截面积，增加静脉血流线性速度，减轻静脉壁扩张并改善瓣膜功能。本文综述了15项单独使用梯度压力弹力袜的随机对照试验。弹力袜使普通外科手术患者DVT相对风险降低64%，全髋关节置换术后降低57%。与肝素等药物联合使用可增强弹力袜的效果；推荐在DVT中度或高度风险患者中联合使用。膝长弹力袜效果相同，应取代大腿长弹力袜。并发症罕见且可避免。
