Takahashi Yoshiki, Takahira Naonobu, Shibuya Manaka, Uchiyama Katsufumi, Fukushima Kensuke, Iwase Dai, Kawamura Tadashi, Miyagi Masayuki, Higashiyama Reiji, Moriya Mitsutoshi, Sakai Kenta, Tsuda Kouji, Sakamoto Miki, Akamine Akihiko, Takaso Masashi
Sensory and Motor Control, Graduate School of Medical Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, Japan.
Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, Japan.
J Orthop Surg (Hong Kong). 2020 Jan-Apr;28(1):2309499020905711. doi: 10.1177/2309499020905711.
There is a pressing need for safe venous thromboembolism (VTE) prophylaxis in orthopedic patients with the highest risks of both venous thrombosis and bleeding. Portable intermittent pneumatic compression device (IPCD) has proven to be effective and safe in patients with a high risk of venous thrombosis and low bleeding risk. Therefore, this study examined the effectiveness, safety, and wearing compliance of portable IPCD for postoperative VTE prophylaxis in patients with the highest risks of both venous thrombosis and bleeding.
The cases consisted of 38 patients who had used a portable IPCD and had the highest risks of both venous thrombosis and bleeding. We examined the incidence of VTE to assess the effectiveness of the portable IPCD, the presence of hemorrhagic adverse events to assess safety, and the wearing rate to assess wearing compliance.
The incidences of asymptomatic and symptomatic deep vein thrombosis were 5.3% and 2.6%, respectively. The incidence of hemorrhagic adverse events was 21.1% in patients who received anticoagulants and wore an IPCD simultaneously and 0% in patients who wore an IPCD but did not receive anticoagulants. The wearing rate (i.e. ≥18 h/day) was 100%.
Portable IPCD has the potential for safe VTE prophylaxis in patients at high risks for both venous thrombosis and bleeding. Therefore, we suggest that such patients use a portable IPCD for VTE prophylaxis.
对于静脉血栓形成和出血风险均最高的骨科患者，迫切需要安全的静脉血栓栓塞症（VTE）预防措施。便携式间歇性气动压迫装置（IPCD）已被证明在静脉血栓形成风险高且出血风险低的患者中有效且安全。因此，本研究探讨了便携式IPCD对静脉血栓形成和出血风险均最高的患者术后预防VTE的有效性、安全性和佩戴依从性。
研究对象为38例使用便携式IPCD且静脉血栓形成和出血风险均最高的患者。我们通过检查VTE的发生率来评估便携式IPCD的有效性，通过检查出血不良事件的发生情况来评估安全性，并通过检查佩戴率来评估佩戴依从性。
无症状和有症状的深静脉血栓形成发生率分别为5.3%和2.6%。同时接受抗凝剂治疗并佩戴IPCD的患者出血不良事件发生率为21.1%，而仅佩戴IPCD但未接受抗凝剂治疗的患者出血不良事件发生率为0%。佩戴率（即每天≥18小时）为100%。
便携式IPCD对静脉血栓形成和出血风险均高的患者具有安全预防VTE的潜力。因此，我们建议此类患者使用便携式IPCD预防VTE。
