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神经肌肉电刺激在全髋关节置换术后增加股静脉血流中的作用

Role of Neuromuscular Electrical Stimulation in Increasing Femoral Venous Blood Flow After Total Hip Prosthesis.

作者信息

Calbiyik Murat, Yılmaz Seyhan

机构信息

Orthopaedics and Traumatology, Hitit University Faculty of Medicine, Corum, TUR.

Cardiovascular Surgery, Amasya University Faculty of Medicine, Amasya, TUR.

出版信息

Cureus. 2022 Sep 17;14(9):e29255. doi: 10.7759/cureus.29255. eCollection 2022 Sep.

Abstract

OBJECTIVE

This study aimed to investigate the role of neuromuscular electrical stimulation (NMES) in increasing femoral venous blood flow after total hip prosthesis and to evaluate its potential effects on preventing postoperative deep vein thrombosis (DVT).

MATERIALS AND METHODS

A total of 64 patients who underwent total hip prosthesis were randomly separated into two groups. The NMES group (n=32) received low-molecular-weight heparin+NMES. And the non-NMES group (n=32) received a low-molecular-weight heparin+compression bandage.

RESULTS

There was no difference between the groups in terms of the presence of preoperative and postoperative leg edema. The calf diameter was significantly lower in the NMES group than in the non-NMES group in both the preoperative (p=0.003) and postoperative (p=0.008) period. Although the femoral vein peak velocity (VPV) was similar between the groups in the preoperative period, it was significantly higher in the NMES group than in the non-NMES group postoperatively (p=0.001). The femoral VPV after total hip prosthesis increased more in the NMES group (43.2%) compared with the non-NMES group (16.3%). In the non-NMES group, the D-dimer value in the preoperative period was lower than on postoperative days one and five (p<0.05). There was no significant difference between the D-dimer values on postoperative days one and five. In the NMES group, a statistically significant difference was determined between the preoperative and postoperative test results (F(2.93)=20.86, p=0.001). The preoperative D-dimer values were compared to the postoperative values on the first and fifth day, and according to the post hoc test results, the D-dimer values were significantly lower on the fifth postoperative day than on the first postoperative day, and the preoperative value was significantly lower than the fifth postoperative day value (p<0.05).  Conclusion: Although the two groups were similar in terms of leg edema, there was a significant increase in femoral VPV in the NMES group. This could indicate a potential effect of NMES in preventing postoperative DVT and needs to be confirmed with further studies.

摘要

目的

本研究旨在探讨神经肌肉电刺激(NMES)在全髋关节置换术后增加股静脉血流中的作用,并评估其对预防术后深静脉血栓形成(DVT)的潜在影响。

材料与方法

总共64例行全髋关节置换术的患者被随机分为两组。NMES组(n = 32)接受低分子肝素+NMES治疗。非NMES组(n = 32)接受低分子肝素+加压绷带治疗。

结果

两组术前和术后腿部水肿情况无差异。术前(p = 0.003)和术后(p = 0.008),NMES组的小腿直径均显著低于非NMES组。虽然术前两组的股静脉峰值流速(VPV)相似,但术后NMES组的VPV显著高于非NMES组(p = 0.001)。与非NMES组(16.3%)相比,NMES组全髋关节置换术后股静脉VPV增加更多(43.2%)。在非NMES组中,术前D-二聚体值低于术后第1天和第5天(p < 0.05)。术后第1天和第5天的D-二聚体值无显著差异。在NMES组中,术前和术后检测结果之间存在统计学显著差异(F(2.93)=20.86,p = 0.001)。将术前D-二聚体值与术后第1天和第5天的值进行比较,根据事后检验结果,术后第5天的D-二聚体值显著低于术后第1天,且术前值显著低于术后第5天的值(p < 0.05)。结论:虽然两组在腿部水肿方面相似,但NMES组的股静脉VPV显著增加。这可能表明NMES在预防术后DVT方面有潜在作用,需要进一步研究证实。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb56/9578661/76799dda0351/cureus-0014-00000029255-i01.jpg

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