Effect of different use time of intermittent pneumatic compression on the incidence of deep vein thrombosis of lower extremities after arthroplasty_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

WANG Liqun , DUAN Shanshan , LIAO Dengbin , LUO Zhenyu ,  HOU Xiaoling

Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China;

Corresponding author：

HOU Xiaoling, Email: 296825257@qq.com

Keywords：

Arthroplasty; intermittent pneumatic compression; deep vein thrombosis; complication

DOI：

10.7507/1002-1892.201907095

Video：

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Objective To investigate the effect of different use time of intermittent pneumatic compression (IPC) on the incidence of deep vein thrombosis (DVT) of lower extremities after arthroplasty.Methods Between October 2018 and February 2019, 94 patients who planned to undergo unilateral total hip or knee arthroplsty and met the selection criteria were randomly divided into a control group (47 cases) and a trial group (47 cases). There was no significant difference in gender, age, surgical site, and surgical reason between the two groups (P>0.05). After returning to the ward, all patients were treated with IPC. And the IPC was used until 9:00 pm on the day after operation in the trial group and until 8:00 am the next day after operation in the control group. The levels of hemoglobin, platelet count, D-dimer, hospital stay, treatment costs, patients’ satisfaction with IPC, the parameters of thromboelastrography [kinetics (K value), freezing angle (α angle), reaction time (R value), maximum amplitude (MA value)], visual analogue scale (VAS) score, circumference difference of calf before and after operation, Pittsburgh sleep assessment score, and the incidence of DVT of lower limbs were recorded and compared between the two groups.Results The K value and D-dimer before operation were significant different between the two groups (P<0.05). There was no significant difference in pre- and post-operative hemoglobin, platelet count, and the other parameters of thromboelastography between the two groups (P>0.05). There was no significant difference in pre- and post-operative VAS scores and post-operative circumference difference of calf between the two groups (P>0.05). The sleep assessment score of the trial group at 1 day after operation was significant lower than that of the control group (t=2.107, P=0.038). There was no significant difference in the hospital stay and treatment costs between the two groups (P>0.05). There was 1 case (2.1%) of DVT, 3 cases (6.4%) of intermuscular venous thrombosis, and 1 case (2.1%) of infection in the trial group, and 2 cases (4.3%), 4 cases (8.5%), and 0 (0) in the control group. The differences were not significant (P>0.05). After the completion of postoperative IPC treatment, the satisfaction rates of using IPC were 89.4%(42/47) in the trial group and 70.2% (33/47) in the control group, and the difference was not significant (χ²=0.097, P=0.104).Conclusion IPC using for a short period of time after arthroplasty do not increase the degrees of the pain and the swelling of calf; it can effectively prevent DVT of the lower extremity, improve the quality of sleep in patients, and is good for the limbs rehabilitation.

Citation： WANG Liqun, DUAN Shanshan, LIAO Dengbin, LUO Zhenyu, HOU Xiaoling. Effect of different use time of intermittent pneumatic compression on the incidence of deep vein thrombosis of lower extremities after arthroplasty. Chinese Journal of Reparative and Reconstructive Surgery, 2020, 34(5): 585-590. doi: 10.7507/1002-1892.201907095 Copy

1.	Peter Harris, Sue Nagy, Nick Vardaxis. Mosby’s Dictionary of Medicine Nursing & Health professions. 7th ed. St. Louis, Mo: Mosby Elsevier, 2006: 115-116.
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10.	Westrich GH, Sculco TP. Prophylaxis against deep venous thrombosis after total knee arthroplasty. Pneumatic plantar compression and aspirin compared with aspirin alone. J Bone Joint Surg (Am), 1996, 78(6): 826-834.
11.	Collins S, Maclntyre C, Hewer I. Thrombelastography: clinical application, interpretation, and transfusion management. AANA J, 2016, 84(2): 129-134.
12.	钱东阳, 白波, 严广斌, 等. 髋膝关节置换围手术期下肢深静脉血栓形成与 D-二聚体及抗凝药的关系. 中华关节外科杂志 (电子版), 2014, 8(2): 181-184.
13.	Berntsen CF, Kristiansen A, Akl EA, et al. Compression stockings for preventing the postthrombotic syndrome in patients with deep vein thrombosis. Am J Med, 2015, 129(4): 447.e1-447.e20.
14.	陈玉桃, 吕畅, 陈少敏, 等. 多种方法预防 ICU 长期住院患者下肢深静脉血栓形成的效果评价. 中国全科医学, 2017, 20(3): 318-322, 330.
15.	李晓红, 王玉. 人工关节置换术后彩色多普勒超声对小腿肌间静脉血栓的诊断价值分析. 实用医技杂志, 2014, 21(4): 387-388.
16.	方针, 厉驹. 超早期间歇充气加压预防全膝关节置换术后下肢深静脉血栓形成. 中国中医骨伤科杂志, 2011, 19(5): 25-27.
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1. Peter Harris, Sue Nagy, Nick Vardaxis. Mosby’s Dictionary of Medicine Nursing & Health professions. 7th ed. St. Louis, Mo: Mosby Elsevier, 2006: 115-116.
2. Colwell CW. The ACCP guidelines for thromboprophylaxis in total hip and knee arthroplasty. Orthopedics, 2009, 32(12 Suppl): 67-73.
3. Autar R. A review of venous thromboprophylaxis in patients undergoing hip fracture surgery (HFS). Int J Orthop Trauma Nurs, 2010, 14(2): 88-95.
4. 中华医学会外科学分会血管外科学组. 深静脉血栓形成的诊断和治疗指南 (第三版). 中国血管外科杂志 (电子版), 2017, 9(4): 250-257.
5. Falck-Ytter Y, Francis CW, Johanson NA, et al. Prevention of VTE in orthopedic surgery patients: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest, 2012, 141(2 Suppl): e278S-e325S.
6. 中华医学会骨科学分会. 中国骨科大手术静脉血栓栓塞症预防指南. 中华关节外科杂志 (电子版), 2009, 3(3): 70-72.
7. 谭湘陵, 陈隆恩, 齐文宁, 等. 机械挤压对大鼠血管内皮细胞一氧化氮合酶表达的调节作用. 微循环学杂志, 2001, 11(3): 7-9.
8. 邱贵兴, 戴尅戎, 杨庆铭, 等. 预防骨科大手术后深静脉血栓形成的专家建议. 中国临床医生, 2006, 34(1): 31-33.
9. Eisele R, Kinzl L, Koelsch T. Rapid-inflation intermittent pneumatic compression for prevention of deep venous thrombosis. J Bone Joint Surg (Am), 2007, 89(5): 1050-1056.
10. Westrich GH, Sculco TP. Prophylaxis against deep venous thrombosis after total knee arthroplasty. Pneumatic plantar compression and aspirin compared with aspirin alone. J Bone Joint Surg (Am), 1996, 78(6): 826-834.
11. Collins S, Maclntyre C, Hewer I. Thrombelastography: clinical application, interpretation, and transfusion management. AANA J, 2016, 84(2): 129-134.
12. 钱东阳, 白波, 严广斌, 等. 髋膝关节置换围手术期下肢深静脉血栓形成与 D-二聚体及抗凝药的关系. 中华关节外科杂志 (电子版), 2014, 8(2): 181-184.
13. Berntsen CF, Kristiansen A, Akl EA, et al. Compression stockings for preventing the postthrombotic syndrome in patients with deep vein thrombosis. Am J Med, 2015, 129(4): 447.e1-447.e20.
14. 陈玉桃, 吕畅, 陈少敏, 等. 多种方法预防 ICU 长期住院患者下肢深静脉血栓形成的效果评价. 中国全科医学, 2017, 20(3): 318-322, 330.
15. 李晓红, 王玉. 人工关节置换术后彩色多普勒超声对小腿肌间静脉血栓的诊断价值分析. 实用医技杂志, 2014, 21(4): 387-388.
16. 方针, 厉驹. 超早期间歇充气加压预防全膝关节置换术后下肢深静脉血栓形成. 中国中医骨伤科杂志, 2011, 19(5): 25-27.
17. Ricky Autar BA. NICE guidelines on reducing the risk of venous thromboembolism (deep vein thrombosis and pulmonary embolism) in patients undergoing surgery. Orthop Nurs, 2007, 11(3-4): 169-176.

Chinese Journal of Reparative and Reconstructive Surgery

Effect of different use time of intermittent pneumatic compression on the incidence of deep vein thrombosis of lower extremities after arthroplasty

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