Vanek V W
Department of Surgery, St. Elizabeth Health Center, Youngstown, Ohio 44501, USA.
Am Surg. 1998 Nov;64(11):1050-8.
This meta-analysis used all original articles from 1966 to June 1996 that fit the preset inclusion criteria to examine the clinical effectiveness of intermittent pneumatic compression (IPC) devices in preventing deep vein thrombosis (DVT) and pulmonary embolism and to compare the results of knee-high sleeves to thigh-high sleeves. IPC devices decreased the relative risk of DVT by 62 per cent when compared with placebo, 47 per cent compared with graduated compression stockings, and 48 per cent compared with mini-dose heparin. IPC devices significantly decreased the relative risk of DVT compared with placebo in high-risk patients such as neurosurgery and major orthopedic surgery patients and in modest risk patients such as general surgery patients. In major orthopedic surgery patients, the incidence of DVT was similar for IPC- and warfarin-treated patients; however, IPC was significantly better than warfarin at decreasing the incidence of calf only DVT, whereas warfarin seemed to be better at decreasing proximal DVT. IPC devices are effective in decreasing the incidence of DVT in patients at moderate to high risk and are probably more efficacious than graduated compression stockings or mini-dose heparin; however, IPC devices are not protective against pulmonary embolism. The data directly comparing the various methods of compression (knee-high versus thigh-high sleeves and graded-sequential versus uniform compression) are sparse and conflicting.
这项荟萃分析使用了1966年至1996年6月间所有符合预设纳入标准的原始文章，以研究间歇性气动压迫（IPC）装置在预防深静脉血栓形成（DVT）和肺栓塞方面的临床有效性，并比较膝上型套筒与大腿型套筒的效果。与安慰剂相比，IPC装置使DVT的相对风险降低了62%；与分级加压弹力袜相比降低了47%；与小剂量肝素相比降低了48%。在神经外科和大型骨科手术等高危患者以及普通外科手术等中度风险患者中，与安慰剂相比，IPC装置显著降低了DVT的相对风险。在大型骨科手术患者中，接受IPC治疗和华法林治疗的患者DVT发生率相似；然而，在降低仅小腿DVT的发生率方面，IPC明显优于华法林，而华法林在降低近端DVT方面似乎更好。IPC装置在降低中度至高度风险患者的DVT发生率方面有效，可能比分级加压弹力袜或小剂量肝素更有效；然而，IPC装置对肺栓塞没有预防作用。直接比较各种压迫方法（膝上型与大腿型套筒以及梯度顺序压迫与均匀压迫）的数据稀少且相互矛盾。
