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与小腿按摩相比,弹性绷带加压预防静脉血栓栓塞的有效性——一项回顾性评估

Usefulness of Elastic Bandage Compression Compared to Calf Massage to Prevent Venous Thromboembolism-A Retrospective Evaluation.

作者信息

Kimura Keishi, Imai Norio, Nozaki Asami, Horigome Yoji, Suzuki Hayato, Kawashima Hiroyuki

机构信息

Department of Regenerative and Transplant Medicine, Division of Orthopedic Surgery, Niigata University Graduate School of Medical and Dental Science, Niigata 951-8510, Japan.

Division of Comprehensive Musculoskeletal Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8520, Japan.

出版信息

J Clin Med. 2024 Jul 25;13(15):4355. doi: 10.3390/jcm13154355.

Abstract

Manual calf massage and passive ankle motion (CaM) can reduce the incidence of venous thromboembolism (VTE) after total hip arthroplasty (THA). However, these methods cannot be used in all patients; thus, elastic bandage (EB) compression is an alternative method. The efficacy of EB compression in preventing VTE has not yet been investigated; thus, this study aimed to compare the effects of EB compression and manual calf massage. Of the 363 patients who underwent unilateral primary THA at our hospital between 1 August 2018 and 31 October 2023, CaM without anticoagulation therapy was administered to 206 patients (CaM group) and 157 patients underwent EB without anticoagulation therapy (EB group). Duplex ultrasonography was performed 7 days postoperatively to check for deep vein thrombosis (DVT) in both legs. The surgical time (122.2 min vs. 155.5 min), the incidence of DVT (4.5% vs. 4.8%) and pulmonary thromboembolism (PTE) (0% vs. 0.7%), intraoperative bleeding (305.4 mL vs. 301 mL), and estimated actual blood loss (846.6 mL vs. 811.6 mL) were not significantly different between the CaM and EB group. However, there was one case of symptomatic PTE in the EB group. The incidences of DVT, PTE, and intraoperative bleeding were not significantly different between the groups. Moreover, EB can be administered to patients with DVT and is considered to be a DVT prophylaxis method that can be used in a larger number of patients. Therefore, we recommend that EB be performed in all the patients undergoing THA.

摘要

手法小腿按摩和被动踝关节活动(CaM)可降低全髋关节置换术(THA)后静脉血栓栓塞症(VTE)的发生率。然而,这些方法并非适用于所有患者;因此,弹力绷带(EB)加压是一种替代方法。EB加压预防VTE的疗效尚未得到研究;因此,本研究旨在比较EB加压和手法小腿按摩的效果。在2018年8月1日至2023年10月31日期间于我院接受单侧初次THA的363例患者中,206例患者接受了不进行抗凝治疗的CaM(CaM组),157例患者接受了不进行抗凝治疗的EB(EB组)。术后7天进行双功超声检查以检查双下肢深静脉血栓形成(DVT)情况。CaM组和EB组之间的手术时间(122.2分钟对155.5分钟)、DVT发生率(4.5%对4.8%)和肺血栓栓塞症(PTE)发生率(0%对0.7%)、术中出血量(305.4毫升对301毫升)以及估计实际失血量(846.6毫升对811.6毫升)无显著差异。然而,EB组有1例症状性PTE。各组之间DVT、PTE和术中出血的发生率无显著差异。此外,EB可用于DVT患者,被认为是一种可用于更多患者的DVT预防方法。因此,我们建议对所有接受THA的患者进行EB治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39d1/11313309/4122df1ff8e8/jcm-13-04355-g001.jpg

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