Department of Medical Physics and Clinical Engineering, University Hospital of Wales, Cardiff, UK.
Phlebology. 2020 Jun;35(5):297-304. doi: 10.1177/0268355519877761. Epub 2019 Sep 25.
There is a lack of good-quality recent clinical data to support the use of mechanical methods to prevent deep vein thrombosis. Recommendations and meta-analyses have to rely on old data from evaluations of devices that are no longer available, with diagnostic methods that are obsolete. The aim of this narrative review is to examine the reasons why better recent evidence is not available, and how this will affect innovation in mechanical deep vein thrombosis prophylaxis. Analysis of recent published trials shows great variability in techniques and technologies, which complicates evaluation of the effectiveness of properties of intermittent pneumatic compression, graduated compression stockings, and electrical stimulation devices. Negative controlled trials have become difficult to conduct, and low rates of deep vein thrombosis have left many comparative trials of devices underpowered. There is a risk that if new approaches to enable clinical research are not developed that technological advancement of mechanical prophylaxis will be inhibited.
目前缺乏高质量的近期临床数据来支持使用机械方法预防深静脉血栓形成。建议和荟萃分析不得不依赖于那些已经不再可用的设备评估中的旧数据，以及已经过时的诊断方法。本叙述性综述的目的是探讨为什么没有更好的近期证据，并说明这将如何影响机械性深静脉血栓预防的创新。对最近发表的试验进行分析表明，间歇气动压缩、分级压缩袜和电刺激设备的技术和技术存在很大的差异，这使得评估间歇性气动压缩、分级压缩袜和电刺激设备的有效性变得复杂。阴性对照试验变得难以进行，并且深静脉血栓形成的低发生率使得许多设备的比较试验都没有足够的效力。如果不开发新的方法来进行临床研究，那么机械预防技术的进步可能会受到阻碍。
