1.Postoperative subacute static progressive stretch does not increase the risk of distal lower limb venous thromboembolism.
Jun-Kun ZHU ; Feng-Feng WU ; Rui-Feng YANG ; Fen-Fen XU ; Ya-Li LIN ; Miao-Fang YE
Chinese Journal of Traumatology 2023;26(3):178-182
PURPOSE:
Static progressive stretch (SPS) can be applied to treat chronic joint stiffness. However, the impacts of subacute application of SPS to the distal lower limbs, where deep vein thrombosis (DVT) is common, on venous thromboembolism remain unclear. This study aims to explore the risk of venous thromboembolism events following subacute application of SPS.
METHODS:
A retrospective cohort study was conducted on patients diagnosed with DVT following a lower extremity orthopedic surgery before being transferred to the rehabilitation ward from May 2017 to May 2022. Patients with unilateral lower limb comminuted para-articular fractures, transferred to rehabilitation ward for further treatment within 3 weeks after operation, followed up more than 12 weeks since initial manual physiotherapy, and diagnosed DVT by ultrasound before rehabilitation course were included in the study. Patients with polytrauma, without evidence of previous peripheral vascular disease or incompetence, had medication for thrombosis treatment or prophylaxis before the operation, detected with paralysis due to nervous system impairment, infected after operation during the regime, or with acute progression of DVT were excluded. The included patients were randomized to the standard physiotherapy and the SPS integrated groups for observation. Associated DVT and pulmonary embolism data were collected during the physiotherapy course to compare the groups. SSPS 28.0 and GraphPad Prism 9 were used for data processing. A p < 0.05 was set significant difference.
RESULTS:
In total of 154 patients with DVT participating in this study, 75 of them were treated with additional SPS for postoperative rehabilitation. The participants in the SPS group showed improved range of motion (12.3° ± 6.7°). However, in the SPS group, there was no difference in thrombosis volume between the start and termination (p = 0.106, p = 0.787, respectively), although difference was seen intra-therapy (p < 0.001). Contingency analysis revealed the pulmonary embolism incidence (OR = 0.703) in the SPS group compared to the mean physiotherapy.
CONCLUSION
The SPS technique is a safe and reliable option to prevent potential joint stiffness without aggravating the risk of distal DVT for postoperative patients suffering from relevant trauma.
Humans
;
Venous Thromboembolism/prevention & control*
;
Venous Thrombosis/etiology*
;
Retrospective Studies
;
Pulmonary Embolism/complications*
;
Lower Extremity
;
Risk Factors
2.Development of an apparatus for preventing deep vein thrombosis.
Xian-ming CHEN ; Chun-ao WEN ; Da-qiang GU
Chinese Journal of Medical Instrumentation 2005;29(5):331-333
A kind of intermittent pneumatic compression (IPC) apparatus is developed to prevent deep vein thrombosis (DVT),which is based on the theory of occurrence and prevention of the DVT and AT89C52 micro-controller. This paper introduces its principle, composition of electromechanical system and the software design. The apparatus has showed its characteristics of easy operation, high intelligence and high reliability.
Equipment Design
;
Physical Therapy Modalities
;
instrumentation
;
Software
;
Thrombolytic Therapy
;
instrumentation
;
Venous Thrombosis
;
prevention & control
4.The Efficacy of Low Molecular Weight Heparin for the Prevention of Venous Thromboembolism after Hip Fracture Surgery in Korean Patients.
Kwang Kyoun KIM ; Yougun WON ; Ye Yeon WON
Yonsei Medical Journal 2016;57(5):1209-1213
PURPOSE: The aim of this study was to investigate the efficacy of low-molecular-weight heparin (LMWH) for the prevention of venous thromboembolism in Korean patients who underwent hip fracture surgery (HFS). MATERIALS AND METHODS: Prospectively, a total 181 cases were classified into the LMWH user group (116 cases) and LMWH non-user group (65 cases). Each group was sub-classified according to fracture types as follows: 81 cases of intertrochanteric fracture (group A: 49, group B: 32) and 100 cases of neck fracture (group C: 67, group D: 33). We compared the incidence of deep vein thrombosis (DVT) and pulmonary embolism (PE) according to LMWH use. RESULTS: Of the 181 cases, four DVTs were found in the LMWH user groups (1 in group A, and 3 in group C). One case of PE was found in LMWH non-user group D. The incidences of DVT and PE showed no statistically significant differences between the LMWH user and non-user groups (p=0.298 and 0.359, respectively). In subgroup analysis, no statistically significant differences were found between groups A and B and between groups C and D. CONCLUSION: The administration of LMWH was not effective in the prevention of venous thromboembolism and PE in the Korean patients who underwent HFS.
Aged
;
Anticoagulants/*therapeutic use
;
Female
;
Heparin, Low-Molecular-Weight/*therapeutic use
;
Hip Fractures/classification/*surgery
;
Humans
;
Male
;
Middle Aged
;
Postoperative Complications/*prevention & control
;
Pulmonary Embolism/etiology/*prevention & control
;
Republic of Korea
;
Venous Thromboembolism/*prevention & control
;
Venous Thrombosis/etiology/*prevention & control
5.Fracture of a Tempofilter II: an Initial Case Report.
Hyung Jun KIM ; Nam Kyu CHANG ; Jae Hoon LIM ; Jae Kyu KIM
Korean Journal of Radiology 2011;12(5):626-628
Tempofilter II is a device that is used for pulmonary embolism prophylaxis. Since the appearance of the Tempofilter II following withdrawal of the Tempofilter I, it has been reported that the Tempofilter II is safe, effective and useful. Here we report on the first case of a fracture of one leg of the filter and this leg was embedded in the inferior vena cava wall in a 62-year-old man with deep vein thrombosis.
Device Removal
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*Equipment Failure
;
Humans
;
Male
;
Middle Aged
;
Pulmonary Embolism/*prevention & control
;
*Vena Cava Filters
;
Venous Thrombosis/*complications/drug therapy
6.Intraoperative IPC combined with 3M warming instrument to prevent lower extremity deep venous thrombosis in patients undergoing proximal femoral anti rotation intramedullary nailing.
Hui-Han WANG ; Yong-Tang WANG ; Liang-Jie LU ; Yue-Ling TIAN ; Jian-Hua MIAO ; Qi-Teng WANG ; Feng-Xin LI
China Journal of Orthopaedics and Traumatology 2022;35(4):349-352
OBJECTIVE:
To explore the effect of intermittent pneumatic compression(IPC) combined with 3M thermometer on the prevention of deep venous thrombosis(DVT) in patients with femoral intertrochanteric fracture.
METHODS:
From March 2016 to August 2019, 127 patients with femoral intertrochanteric fractures who underwent proximal femoral nail antirotation(PFNA) were retrospectively analyzed. They were divided into two groups according to different methods of thrombus prevention and treatment. Among them, 63 patients in group A did not use IPC and 3M thermometer;64 cases in group B were treated with IPC combined with 3M thermometer. Color Doppler ultrasound was used to dynamically monitor the DVT and changes of lower limbs during perioperative period. The venous thrombosis of lower limbs was monitored at 0, 24, 72 h and > 72 h after operation(recheck every 3 days until discharge).
RESULTS:
Occurrence of DVT of lower limbs after PFNA operation in two groups:there were 5 cases (7.8%) in group B and 20 cases (31.7%) in group A, there was significant difference between two groups (P=0.001). There was no significant difference in lower limb DVT between two groups at 0, 72 and > 72 h after operation(P>0.05), but the formation rate of group A was significantly higher than that of group B at 24 h after operation (P=0.049). There was no significant difference in DVT formation between group A and group B(P>0.05). However, the formation of DVT in group A was significantly higher than that in group B(P=0.012).
CONCLUSION
Intraoperative IPC combined with 3M thermostat can effectively prevent DVT of lower limbs in patients undergoing PFNA surgery.
Femoral Fractures/surgery*
;
Fracture Fixation, Intramedullary/methods*
;
Hip Fractures/surgery*
;
Humans
;
Lower Extremity/surgery*
;
Retrospective Studies
;
Venous Thrombosis/prevention & control*
8.Two mechanical methods for thromboembolism prophylaxis after gynaecological pelvic surgery: a prospective, randomised study.
Jie GAO ; Zhen-Yu ZHANG ; Zhan LI ; Chong-Dong LIU ; Yu-Xin ZHAN ; Bao-Li QIAO ; Cui-Qin SANG ; Shu-Li GUO ; Shu-Zhen WANG ; Ying JIANG ; Na ZHAO
Chinese Medical Journal 2012;125(23):4259-4263
BACKGROUNDVenous thromboembolism is known to be an important social and health care problem because of its high incidence among patients who undergo surgery. Studies on the mechanical prophylaxis of thromboembolism after gynaecological pelvic surgery are few. The aim of our study was to evaluate the effect of mechanical thromboembolism prophylaxis after gynaecological pelvic surgery using a combination of graduated compression stockings (GCS) and intermittent pneumatic compression (IPC) or GCS alone.
METHODSThe study was performed on 108 patients who were randomly assigned to two groups. The first group received GCS before the operation and IPC during the operation (IPC + GCS group). The second group received GCS before the operation (GCS group). To analyze the effect of the preventive measures and the laboratory examination on the incidence of thrombosis and to compare the safety of these measures, the incidence of adverse reactions was assessed.
RESULTSThe morbidity associated with DVT was 4.8% (5/104) in the IPC + GCS group and 12.5% (14/112) in the GCS group. There were significant statistical differences between the two groups. There were no adverse effects in either group.
CONCLUSIONSThe therapeutic combination of GCS and IPC was more effective than GCS alone for thrombosis prevention in high-risk patients undergoing gynaecological pelvic surgery, and there were no adverse effects in either group.
Aged ; Female ; Gynecologic Surgical Procedures ; adverse effects ; Humans ; Intermittent Pneumatic Compression Devices ; Male ; Middle Aged ; Pelvis ; surgery ; Stockings, Compression ; Thromboembolism ; etiology ; prevention & control ; Venous Thrombosis ; etiology ; prevention & control
9.Prevention and medical treatment of deep vein thrombosis in patients with abdominal tumors after the radical operation.
Liang HE ; Jiang WANG ; Lin NAN ; Bing YAN ; Xiao-Qian GAI ; Yong-Jiu ZHANG
Chinese Journal of Surgery 2011;49(1):57-60
OBJECTIVETo summarize the prevention and treatment experience of deep vein thrombosis in patients with abdominal tumors after standardized resection and lymph node dissection, and to investigate a standard therapeutic measure of thrombosis prevention in these patients.
METHODSThe clinical data of 548 patients who received radical operation and standardized lymph node dissection for abdominal tumors from January 2007 to April 2010 were analyzed retrospectively. According to different therapeutic scheme and time, the patients were divided into three groups: Group 1 included 163 cases from January 2007 to March 2008 were treated with compound Danshen injection 0.2 g and low molecular weight dextran 500 ml on the same day of surgery for 7 days; Group 2 included 149 cases from April 2008 to March 2009 were treated with the same regimen as that in Group 1 plus low molecular heparin 40 mg on the same day of surgery for 7 days; Group 3 included 236 cases from April 2009 to April 2010 were treated with the same regimen as that in Group 1 plus low molecular heparin on the third day of surgery for 7 days. The treatment effects and the complications in the three groups were analyzed and compared.
RESULTSSixty-four (39.3%) cases were D-Dimer positive and 15 (9.2%) cases were DVT positive under color Doppler ultrasound examination in Group 1; and those were 38 (25.5%) and 3 (2.0%) in Group 2; and 62 (26.3%) and 6(2.5%) in Group 3. Overall observation, the incidences of thrombosis in Group 2 and 3 were obviously lower than that of Group 1, but there was no significant difference between Group 2 and 3. Earlier use of low molecular heparin would lead to some complications.
CONCLUSIONSIt brings better effects in thrombosis prevention by using compound Danshen injection and low molecular weight dextran on the day of surgery, with low molecular heparin on the third day of surgery.
Abdominal Neoplasms ; surgery ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications ; prevention & control ; Retrospective Studies ; Venous Thrombosis ; etiology ; prevention & control ; therapy