Nakanishi Keisuke, Takahira Naonobu, Sakamoto Miki, Yamaoka-Tojo Minako, Katagiri Masato, Kitagawa Jun
Sensory and Motor Control, Functional Restration Sciences, Kitasato University Graduate School of Medical Sciences, 1-15-1, Kitasato, Minami-ku, Sagamihara-Shi, Kanagawa, 252-0373, Japan.
Department of Orthopaedic Surgery, Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitasato, Minami-ku, Sagamihara-Shi, Kanagawa, 252-0373, Japan.
J Thromb Thrombolysis. 2016 Nov;42(4):579-84. doi: 10.1007/s11239-016-1403-y.
Patients with plaster-cast immobilization of the lower limb have an estimated venous thromboembolism rate of 2.5 % without prophylaxis, which includes many fatal cases. However, there is no practical physical prophylaxis for deep-vein thrombosis (DVT) in these patients. The aim of this study was to examine the effects of intermittent pneumatic compression on the thigh alone (IPC to the thigh) on peak blood velocity (PBV) in the legs and to consider the possibility that IPC of the thigh could be used as physical prophylaxis for DVT in patients with plaster-cast immobilization of the lower leg. Nine healthy male volunteers and eighteen elderly males were recruited. We immobilized each subject's right lower leg and ankle with a plaster splint, and applied the ActiveCare+S.F.T.(®) (Medical Compression Systems, Inc.) device to each subject's right thigh. The PBV in the superficial femoral vein (PBVFV) and the popliteal vein (PBVPV) were measured using duplex Doppler ultrasonography. IPC to the thigh resulted in a 2.3-fold increase in PBVFV and a 3.0-fold increase in PBVPV compared with resting at supine in the elderly group. Although IPC to the thigh also increased PBVFV and PBVPV significantly in the sitting position, the change ratios of PBV in the supine and sitting positions were equal (2.6-fold increase in PBVFV and 2.9-fold increase in PBVPV). IPC to the thigh in supine and sitting positions significantly increased PBVFV and PBVPV, and could be a useful prophylaxis for DVT in patients with plaster-cast immobilization of the lower leg.
下肢采用石膏固定的患者，在未进行预防的情况下，静脉血栓栓塞率估计为2.5%，其中包括许多致命病例。然而，对于这些患者，尚无针对深静脉血栓形成（DVT）的实用物理预防措施。本研究的目的是研究仅对大腿进行间歇性气动压迫（IPC至大腿）对腿部峰值血流速度（PBV）的影响，并探讨大腿IPC可作为小腿石膏固定患者DVT物理预防措施的可能性。招募了9名健康男性志愿者和18名老年男性。我们用石膏夹板固定每个受试者的右小腿和脚踝，并将ActiveCare+S.F.T.(®)（Medical Compression Systems, Inc.）装置应用于每个受试者的右大腿。使用双功多普勒超声测量股浅静脉（PBVFV）和腘静脉（PBVPV）中的PBV。与老年组仰卧休息时相比，对大腿进行IPC使PBVFV增加2.3倍，PBVPV增加3.0倍。尽管在坐位时对大腿进行IPC也显著增加了PBVFV和PBVPV，但仰卧位和坐位时PBV的变化率相等（PBVFV增加2.6倍，PBVPV增加2.9倍）。仰卧位和坐位时对大腿进行IPC显著增加了PBVFV和PBVPV，可能是小腿石膏固定患者DVT的一种有效预防措施。
