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小腿肌肉刺激在预防印度髋部周围骨折手术患者深静脉血栓形成中的作用

Role of calf muscle stimulation in the prevention of DVT in Indian patients undergoing surgeries for fractures around the hip.

作者信息

Goyal Aman, Arora Sumit, Batra Sumit, Sharma Rohit, Mittal Mahesh Kumar, Sharma Vinod K

机构信息

Department of Orthopaedic Surgery, Maulana Azad Medical College and Associated LokNayak Hospital, New Delhi, India.

出版信息

Indian J Orthop. 2012 Sep;46(5):542-7. doi: 10.4103/0019-5413.101034.

Abstract

BACKGROUND

The venous stasis of soleal vein during surgery may be an important factor in the development of deep vein thrombosis (DVT). The stimulation of calf muscle during surgery may help in preventing DVT. The present study is conducted to evaluate the role of peroperative calf muscle electrostimulation in prevention of DVT in patients undergoing surgeries around the hip joint.

MATERIALS AND METHODS

The study comprised 200 patients undergoing surgeries around the hip joint. The patients having risk factors (such as previous myocardial infarction, malignancies, paraplegia or lower limb monoplegia, previous history of DVT or varicose veins, etc.) for the development of DVT were excluded. They were randomized into two groups: 100 cases were given peroperative calf muscle electrostimulation for DVT prophylaxis (Group A) and the remaining 100 patients were taken as controls without any prophylaxis (Group B). The color Doppler ultrasound was performed to exclude pre-existing DVT and on 7(th) day postoperative to find out the incidence of DVT in both the groups.

RESULTS

Two patients among Group A and six patients among Group B demonstrated DVT on ultrasonography, but the difference was not found to be statistically significant (P=0.279). None of the patients had any clinical evidence of DVT.

CONCLUSION

The role of peroperative calf muscle electrostimulation for DVT prophylaxis remains controversial. The risk of developing DVT in patients undergoing surgeries around the hip joint is very less in patients analysed in our series.

摘要

背景

手术期间比目鱼静脉的静脉淤滞可能是深静脉血栓形成(DVT)的一个重要因素。手术期间对小腿肌肉的刺激可能有助于预防DVT。本研究旨在评估围手术期小腿肌肉电刺激在预防髋关节周围手术患者发生DVT中的作用。

材料与方法

本研究纳入200例接受髋关节周围手术的患者。排除有DVT发生风险因素(如既往心肌梗死、恶性肿瘤、截瘫或下肢单瘫、既往DVT或静脉曲张病史等)的患者。将他们随机分为两组:100例给予围手术期小腿肌肉电刺激以预防DVT(A组),其余100例患者作为对照组不进行任何预防措施(B组)。术前进行彩色多普勒超声检查以排除既往存在的DVT,并在术后第7天检查两组DVT的发生率。

结果

A组有2例患者、B组有6例患者超声检查显示有DVT,但差异无统计学意义(P = 0.279)。所有患者均无DVT的临床证据。

结论

围手术期小腿肌肉电刺激预防DVT的作用仍存在争议。在我们系列分析的患者中,髋关节周围手术患者发生DVT的风险非常低。

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