Olivier L C, Ostovan D, Heywinkel W, Kendoff D, Wolfhard U
St Josefs-Hospital, Klinik für Orthopädie, Unfall- und Handchirurgie, Krankenhausstr 13, Cloppenburg, Germany.
Unfallchirurg. 2007 Nov;110(11):981-7. doi: 10.1007/s00113-007-1333-4.
Despite the broad use of low molecular weight heparin, deep vein thrombosis is still a relevant risk for immobilized patients in orthopedic surgery. Patients can reduce this risk by active training exercises with a muscle pump. The aim of this study was to test the acceptance and effect of a self-developed training device to accelerate venous return as well as a technical optimization. The device was installed for in-patients in orthopedic and traumatology departments.
A simple pillow-like device was developed, which can be positioned against the foot end of the patient's bed (Phlebostep). The device gives a sound-based feedback to the patient while pushing actively against it with complete ankle flexion. A digital integrated counter device allows direct feedback to the physician and nursing staff at any time. Initial testing including duplex sonography for venous flow measurements were done on 10 orthopedic in-patients. Prior testing on 7 healthy volunteers was carried out to define the effect of various amounts of pressure on the Phlebostep on the venous blood flow. Additionally, a questionnaire on the general acceptance and user-friendliness was filled out by 84 patients who had used the Phlebostep.
The optimal pressure force was defined as 35 mmHg for further measurements. The venous flow measurements in the 10 postoperative patients revealed an increased venous blood flow in the affected leg by an average of 99.9%. Analysis of the questionnaire from the 84 patients showed a high degree of acceptance.
In addition to the technical feasibility, this study showed that use of the Phlebostep resulted on average in a doubling of venous return. The increase of venous flow offers an additional effective device for thrombosis prophylaxis through patient's own active movements and is clearly superior to the use of devices such as antithrombosis stockings alone. The Phlebostep found a high degree of acceptance with the patients.
尽管低分子量肝素被广泛使用，但深静脉血栓形成仍是骨科手术中制动患者的一个相关风险。患者可通过肌肉泵主动训练运动来降低此风险。本研究的目的是测试一种自行研发的用于加速静脉回流的训练装置的接受度和效果以及技术优化。该装置安装在骨科和创伤科的住院患者处。
研发了一种简单的枕头状装置（静脉助推器），可放置在患者床头脚部位置。当患者以完全踝关节屈曲状态主动推抵该装置时，它会向患者提供基于声音的反馈。数字集成计数器装置可随时向医生和护理人员提供直接反馈。对10名骨科住院患者进行了包括双功超声静脉血流测量在内的初步测试。此前对7名健康志愿者进行了测试，以确定静脉助推器上不同压力量对静脉血流的影响。此外，84名使用过静脉助推器的患者填写了一份关于总体接受度和用户友好性的问卷。
将进一步测量的最佳压力定义为35 mmHg。对10名术后患者的静脉血流测量显示，患侧腿部静脉血流平均增加了99.9%。对84名患者问卷的分析显示接受度很高。
除了技术可行性外，本研究表明使用静脉助推器平均可使静脉回流增加一倍。静脉血流的增加为通过患者自身主动运动预防血栓形成提供了一种额外的有效装置，明显优于单独使用抗血栓袜等装置。静脉助推器获得了患者的高度认可。
