Efficacy of intermittent pneumatic compression combined with drugs in the prevention of lower extremity deep venous thrombosis after joint replacement and its risk factors
10.3760/cma.j.cn341190-20210723-00840
- VernacularTitle:IPC联合药物预防关节置换术后下肢深静脉血栓的效果及其发生的危险因素分析
- Author:
Shengjun JIN
1
;
Yirong FAN
;
Xiaoyan ZHU
;
Shanshan XIE
Author Information
1. 金华市人民医院外科，金华 321000
- Keywords:
Arthroplasty, replacement;
Venous thrombosis;
Lower extremity;
Prothrombin time;
Fibrinogen;
Root cause analysis;
Heparin, low-molecular-weight
- From:
Chinese Journal of Primary Medicine and Pharmacy
2022;29(9):1359-1363
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the efficacy of intermittent pneumatic compression (IPC) combined with drugs in the prevention of lower extremity deep venous thrombosis (DVT) after joint replacement and its risk factors.Methods:A total of 80 patients receiving joint replacement surgery in Jinhua People's Hospital from January 2019 to December 2020 were included in this study. They were randomly divided into observation and control groups, with 40 patients in each group. To prevent lower extremity deep venous thrombosis, the control group was given low molecular weight heparin, and the observation group was given IPC in addition to DVT. The incidence of DVT post-surgery and coagulation function pre- and post-surgery were compared between the two groups. The incidence of adverse reactions was recorded in each group. In addition, 40 patients who developed DVT after joint replacement surgery from January 2019 to December 2020 (DVT group) and 40 patients who did not develop DVT (no DVT group) were included. The factors influencing the occurrence of DVT were analyzed by binary logistic regression.Results:The incidence of DVT in the observation group was significantly lower than that in the control group (5.00% vs. 20.00%, χ2 = 4.11, P < 0.05). At 7 days after surgery, prothrombin time, activated partial thromboplastin time, fibrinogen in the observation group were (11.73 ± 0.51) seconds, (27.05 ± 1.17) seconds, (3.89 ± 0.52) g/L, respectively, which were significantly lower than (12.03 ± 0.43) seconds, (27.65 ± 1.30) seconds, and (4.18 ± 0.59) g/L in the control group ( t = 2.84, 2.33, 2.17, all P < 0.05). There was no significant difference in the incidence of adverse reactions between observation and control groups (5.00% vs. 2.50%, χ2 = 0.00, P > 0.05). There were significant differences in age, body mass index, history of hypertension, and operative time between patients with DVT and those without DVT ( χ2 = 4.11, 5.16, 4.71, 8.65, all P < 0.05). Logistic regression analysis showed that age ( OR = 1.57, 95% CI = 1.239 - 2.014), body mass index ( OR = 6.71, 95% CI = 1.298 - 34.794), history of hypertension ( OR = 3.23, 95% CI = 1.980 - 5.296), operative time ( OR = 6.29, 95% CI = 2.058 - 19.225) were independent risk factors for DVT after joint replacement surgery (all P < 0.05). Conclusion:There are many factors that influence the occurrence of DVT after joint replacement surgery. Intermittent pneumatic compression combined with drugs for prevention of lower extremity DVT is safe and effective.
