Westrich G H, Specht L M, Sharrock N E, Windsor R E, Sculco T P, Haas S B, Trombley J F, Peterson M
The Hospital for Special Surgery, New York, NY 10021, USA.
J Bone Joint Surg Br. 1998 Nov;80(6):1057-66. doi: 10.1302/0301-620x.80b6.8627.
We performed a crossover study to evaluate the haemodynamic effect of active dorsal to plantar flexion and seven pneumatic compression devices in ten patients who had a total knee arthroplasty. Using the Acuson 128XP/10 duplex ultrasound unit with a 5MHz linear array probe, we assessed the augmentation of peak venous velocity and venous volume above and below the junction of the greater saphenous and common femoral veins in order to study both the deep and superficial venous systems. The pneumatic compression devices evaluated included two foot pumps (A-V Impulse System and PlexiPulse Foot), a foot-calf pump (PlexiPulse Foot-Calf), a calf pump (VenaFlow System) and three calf-thigh pumps (SCD System, Flowtron DVT and Jobst Athrombic Pump). The devices differed in a number of ways, including the length and location of the sleeve and bladder, the frequency and duration of activation, the rate of pressure rise, and the maximum pressure achieved. A randomisation table was used to determine the order of the test conditions for each patient. The enhancement of peak venous velocity occurred primarily in the deep venous system below the level of the saphenofemoral junction. The increases in peak venous velocity were as follows: active dorsal to plantar flexion 175%; foot pumps, A-V Impulse System 29% and PlexiPulse 65%; foot-calf pump, PlexiPulse, 221%; calf pump, VenaFlow, 302% and calf-thigh pumps, Flowtron DVT 87%, SCD System 116% and Jobst Athrombic Pump 263%. All the devices augmented venous volume, the greatest effect being seen with those incorporating calf compression. The increases in ml/min were found in the deep venous system as follows: foot pumps, A-V Impulse System 9.6 and PlexiPulse Foot 16.7; foot-calf pump, PlexiPulse, 38.1; calf pump, VenaFlow, 26.2; calf-thigh pumps, Flowtron DVT 61.5, SCD System 34.7 and Jobst Athrombic Pump 82.3. Active dorsal to plantar flexion generated 8.5 ml for a single calf contraction.
我们进行了一项交叉研究，以评估主动背屈和七种气动压缩装置对10例全膝关节置换患者的血流动力学影响。使用配备5MHz线性阵列探头的Acuson 128XP/10双功能超声仪，我们评估了大隐静脉与股总静脉交界处上下的峰值静脉流速和静脉容量的增加情况，以便研究深静脉和浅静脉系统。所评估的气动压缩装置包括两台足部泵（A-V脉冲系统和PlexiPulse足部泵）、一台足部-小腿泵（PlexiPulse足部-小腿泵）、一台小腿泵（VenaFlow系统）和三台小腿-大腿泵（SCD系统、Flowtron DVT和Jobst抗血栓泵）。这些装置在许多方面存在差异，包括套筒和气囊的长度和位置、激活频率和持续时间、压力上升速率以及达到的最大压力。使用随机化表来确定每位患者的测试条件顺序。峰值静脉流速的增强主要发生在隐股静脉交界处水平以下的深静脉系统中。峰值静脉流速的增加情况如下：主动背屈为175%；足部泵，A-V脉冲系统为29%，PlexiPulse为65%；足部-小腿泵，PlexiPulse为221%；小腿泵，VenaFlow为302%；小腿-大腿泵，Flowtron DVT为87%，SCD系统为116%，Jobst抗血栓泵为263%。所有装置均增加了静脉容量，其中以包含小腿压缩的装置效果最为显著。深静脉系统中每分钟增加的毫升数如下：足部泵，A-V脉冲系统为9.6，PlexiPulse足部泵为16.7；足部-小腿泵，PlexiPulse为38.1；小腿泵，VenaFlow为26.2；小腿-大腿泵，Flowtron DVT为61.5，SCD系统为34.7，Jobst抗血栓泵为82.3。单次小腿收缩时，主动背屈产生8.5毫升。
