Schwahn-Schreiber C, Breu F X, Rabe E, Buschmann I, Döller W, Lulay G R, Miller A, Valesky E, Reich-Schupke S
, Eschstr. 10, 21762, Otterndorf, Deutschland.
Venenzentrum am Tegernsee, Tegernseerstr.3, 83703, Gmund am Tegernsee, Deutschland.
Hautarzt. 2018 Aug;69(8):662-673. doi: 10.1007/s00105-018-4219-1.
Under the direction of the German Society of Phlebology (Deutsche Gesellschaft für Phlebologie) and in cooperation with other specialist associations, the S1 guideline on intermittent pneumatic compression (IPC) was adopted in January 2018. It replaces the previous guideline from March 2005. The aim of the guideline is to optimize the indication and therapeutic use of IPC in vascular diseases and edema. An extensive literature search of MEDLINE, existing guidelines, and work relevant to the topic was performed. In view of the often methodologically weak study quality with often small numbers of cases and heterogeneous treatment protocols, recommendations can often only be derived from the available data using good clinical practice/expert consensus. Intermittent pneumatic compression is used for thromboembolism prophylaxis, decongestive therapy for edema, and to positively influence arterial and venous circulation to improve clinical symptoms and accelerate ulcer healing in both the outpatient and inpatient care setting. The therapy regimens and devices used depend on the indication and target location. They can be used as outpatient and inpatient devices as well as at home for long-term indications. A target indication is thrombosis prophylaxis. IPC should be used in severe chronic venous insufficiency (stages C4b to C6), in extremity lymphedema as an add-on therapy and in peripheral arterial occlusive disease (PAOD) with stable intermittent claudication or critical ischemia. IPC can be used in post-traumatic edema, therapy-resistant venous edema, lipedema and hemiplegia with sensory deficits and edema. Absolute and relative contraindications to IPC must be taken into account and risks considered and avoided as far as possible. Adverse events are extremely rare if IPC is used correctly. If the indication and application are correct-also as an add-on therapy-it is a safe and effective treatment method, especially for the treatment of the described vascular diseases and edema as well as thrombosis prophylaxis.
在德国静脉病学会(Deutsche Gesellschaft für Phlebologie)的指导下,并与其他专业协会合作,关于间歇性气动压迫(IPC)的S1指南于2018年1月通过。它取代了2005年3月的先前指南。该指南的目的是优化IPC在血管疾病和水肿中的适应症及治疗应用。对MEDLINE、现有指南以及与该主题相关的工作进行了广泛的文献检索。鉴于研究质量往往在方法学上较弱,病例数量通常较少且治疗方案存在异质性,通常只能根据现有数据采用良好临床实践/专家共识得出建议。间歇性气动压迫用于血栓栓塞预防、水肿的消肿治疗,并积极影响动静脉循环,以改善临床症状并加速门诊和住院护理环境中的溃疡愈合。所使用的治疗方案和设备取决于适应症和目标部位。它们可作为门诊和住院设备使用,也可用于长期适应症的家庭治疗。一个目标适应症是血栓形成预防。IPC应用于严重慢性静脉功能不全(C4b至C6期)、作为附加治疗用于肢体淋巴水肿以及患有稳定间歇性跛行或严重缺血的外周动脉闭塞性疾病(PAOD)。IPC可用于创伤后水肿、难治性静脉水肿、脂肪性水肿以及伴有感觉障碍和水肿的偏瘫。必须考虑IPC的绝对和相对禁忌症,并尽可能考虑和避免风险。如果正确使用IPC,不良事件极为罕见。如果适应症和应用正确——作为附加治疗也是如此——它是一种安全有效的治疗方法,尤其适用于治疗所述的血管疾病和水肿以及血栓形成预防。