Yang Jin, Qi Haiou, Huang Jingying, Xu Miaomiao, Xue Zihao, Wang Yina
Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310020, China.
Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310020, China.
Complement Ther Clin Pract. 2025 Feb;58:101932. doi: 10.1016/j.ctcp.2024.101932. Epub 2024 Nov 15.
The effectiveness of neuromuscular electrical stimulation (NMES) for venous thromboprophylaxis is still debatable. This systematic review and meta-analysis evaluated the effectiveness and safety of NMES among surgical patients undergoing elective surgery.
Randomized controlled trials (RCTs) and quasi-experimental studies were retrieved from PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, CINAHL, Wanfang, China National Knowledge Infrastructure and Chinese Biomedical Database from their inception to February 1st, 2024. Two reviewers independently assessed, extracted, and appraised the included studies. The meta-analyses incorporated two primary comparisons: NMES versus basic thromboprophylaxis and NMES versus other mechanical thromboprophylaxis. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach was used to assess the certainty of evidence.
Sixteen studies involving 1685 participants were analysed, with all outcomes being assessed within 14 days postoperatively. Compared with basic thromboprophylaxis and graduated compression stockings, NMES significantly reduced the incidence of postoperative deep venous thrombosis (all p < 0.05). Compared with basic thromboprophylaxis and other mechanical basic thromboprophylaxis, NMES significantly improved postoperative D-dimer level and femoral venous peak velocity (all p < 0.05). No studies reported NMES device-related adverse events. The GRADE results showed low to very low certainty levels of evidence.
NMES is a promising mechanical strategy for venous thromboprophylaxis in surgical patients. High-quality RCTs are required to elucidate the therapeutic benefits of NMES compared to other mechanical prevention methods and to standardize its clinical application.
神经肌肉电刺激（NMES）用于静脉血栓预防的有效性仍存在争议。本系统评价和荟萃分析评估了NMES在接受择期手术的外科患者中的有效性和安全性。
从PubMed、Embase、Cochrane对照试验中央注册库、Web of Science、CINAHL、万方、中国知网和中国生物医学数据库中检索从建库至2024年2月1日的随机对照试验（RCT）和准实验研究。两名研究者独立评估、提取和评价纳入研究。荟萃分析纳入了两项主要比较：NMES与基本血栓预防以及NMES与其他机械性血栓预防。采用推荐分级、评估、制定和评价（GRADE）方法评估证据的确定性。
分析了16项涉及1685名参与者的研究，所有结局均在术后14天内进行评估。与基本血栓预防和分级压力袜相比，NMES显著降低了术后深静脉血栓形成的发生率（所有p<0.05）。与基本血栓预防和其他机械性基本血栓预防相比，NMES显著改善了术后D-二聚体水平和股静脉峰值流速（所有p<0.05）。没有研究报告与NMES设备相关的不良事件。GRADE结果显示证据的确定性水平为低至极低。
NMES是一种有前景的用于外科患者静脉血栓预防的机械策略。需要高质量的RCT来阐明NMES与其他机械预防方法相比的治疗益处，并规范其临床应用。
