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是否需要穿压缩袜以及应该穿多久以预防血栓后综合征?一项随机对照试验的荟萃分析。

Is it necessary to wear compression stockings and how long should they be worn for preventing post thrombotic syndrome? A meta-analysis of randomized controlled trials.

机构信息

Department of Orthopaedics, Xiangya Hospital, Central South University, #87 Xiangya Road, Changsha 410008, Hunan, China.

Department of Orthopaedics, Xiangya Hospital, Central South University, #87 Xiangya Road, Changsha 410008, Hunan, China; Hunan Key Laboratory of Joint Degeneration and Injury, Changsha, Hunan, China; Hunan Engineering Research Center of Osteoarthritis, Changsha, Hunan, China; National Clinical Research Center of Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China.

出版信息

Thromb Res. 2023 May;225:79-86. doi: 10.1016/j.thromres.2023.03.016. Epub 2023 Apr 1.

Abstract

BACKGROUND

Post thrombotic syndrome (PTS) is a serious complication of deep venous thrombosis (DVT). There were always debates on the efficacy of elastic compression stockings (ECS) in prevention for post thrombotic syndrome.

OBJECTIVE

To assess effects of elastic compression stockings and ECS's wearing time on post thrombotic syndrome after diagnosis of deep venous thrombosis.

METHODS

PubMed, Cochrane Library, Embase, Web of Science were last searched on 23 November 2022 for studies assessing effects of elastic compression stockings or theirs wearing time on post thrombotic syndrome after diagnosis of deep venous thrombosis.

RESULTS

9 randomized controlled trials were included. Wearing elastic compression stockings was associated with a statistically reduction in the overall post thrombotic syndrome rate (RR 0.73, 95 % CI 0.53 to 1.00; P = 0.05; I = 82 %). No significant difference in severe post thrombotic syndrome rate, recurrent deep venous thrombosis rate, and death rate was seen whether wearing elastic compression stockings or not. The pooled effect of studies comparing different wearing time of elastic compression stockings showed no significant difference in post thrombotic syndrome rate, severe and moderate post thrombotic syndrome rate, recurrent deep venous thrombosis syndrome rate and death rate.

CONCLUSIONS

Wearing ECS can reduce the risk of developing PTS after DVT and a wearing time of less than or equal to 1 year is comparable to 2 years wearing. The results support ECS's role as a foundation therapy for preventing PTS.

摘要

背景

血栓后综合征(PTS)是深静脉血栓(DVT)的严重并发症。关于弹性压迫袜(ECS)在预防 PTS 方面的疗效一直存在争议。

目的

评估深静脉血栓诊断后使用弹性压迫袜及穿着时间对 PTS 的影响。

方法

检索 PubMed、Cochrane Library、Embase、Web of Science 数据库,最后检索日期为 2022 年 11 月 23 日,以评估弹性压迫袜或其穿着时间对深静脉血栓诊断后 PTS 的影响。

结果

纳入 9 项随机对照试验。穿着弹性压迫袜与 PTS 总发生率降低相关(RR 0.73,95%CI 0.53 至 1.00;P=0.05;I²=82%)。穿着弹性压迫袜与不穿相比,严重 PTS 发生率、复发性深静脉血栓形成率和死亡率无显著差异。比较不同弹性压迫袜穿着时间的研究的汇总效应显示,PTS 发生率、严重和中度 PTS 发生率、复发性深静脉血栓形成综合征发生率和死亡率无显著差异。

结论

穿着 ECS 可降低 DVT 后 PTS 的发病风险,穿着时间小于或等于 1 年与穿着 2 年相当。结果支持 ECS 作为预防 PTS 的基础治疗方法。

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