ABSTRACT
Objective To investigate the prevention effects of antithrombotic pressure pump combined with graduated compression stockings (GCS) on incidence of postoperative lower extremity deep venous thrombosis (LEDVT) in breast cancer patients. Methods A total of 363 cases of breast cancer patients after operation were divided into routine care group (124 cases) according to the method of random number table, pressure group (127 cases) and combined treatment group (112 cases). The routine care group received conventional LEDVT ankle pump exercises. The pressure group used GCS besides the routine intervention. The combined group received GCS and antithrombotic pressure pump besides the routine intervention. Then the levels of thrombosis markers, D-dimers,platelets, and incidences of LEDVT were examined in the three groups. Results Before operation, no significant differences between the levels of prothrombin time (PT), activated partial prothrombin time (APTT), thrombin time (TT), fibrinogen, plasma D-dimer and platelets (P>0.05). After operation, the levels of PT, APTT, TT, fibrinogen, plasma D-dimer and platelets in three groups were (10.22 ± 0.76) s, (27.24 ± 3.68) s, (14.60 ± 0.88) s, (2.94 ± 0.59) mg/L, (0.31 ± 0.21) mg/L, (288.48 ± 71.29) × 109/L, (10.73 ± 0.79) s, (27.35 ± 2.54) s, (14.71± 1.76) s, (4.12±1.09) mg/L, (0.46±0.38) mg/L, (284.26±70.98) ×109/L and (11.11±0.64) s、(28.52± 2.74) s, (14.33± 1.02) s, (4.42±1.20) mg/L, (0.35±0.33) mg/L, (258.79±62.35) ×109/L, respectively. There was significant difference among these groups (F=5.71-87.31, P<0.01). The differences on PT, APTT, fibrinogen and D-dimers between combined treatment group and routine care group were statistically significant (P<0.05). The differences on PT, fibrinogen and platelets between combined treatment group and pressure group were statistically significant (P<0.05). The differences on PT, APTT, fibrinogen and D-dimers between routine care group and pressure group were statistically significant (P<0.05). Through one months of follow-up, the incidence of LEDVT in routine care group, pressure group and combined treatment group were 12.10％(15/124),3.15％(4/127),0.89％(1/112), respectively. There was significant difference among these groups (χ2=16.279,P<0.01). Conclusions The application of antithrombotic pressure pump combined with GCS significantly improves the postoperative hypercoagulable states in breast cancer patients. The combined treatment reduces the incidence of LEDVT without bleeding risk. Therefore, antithrombotic pressure pump combined with GCS is recommended for clinical use in the postoperative breast cancer patients.
ABSTRACT
Venous thromboembolism (VTE) represents one of the leading causes of mortality and morbidity in acutely ill medical patients. VTE prophylaxis can be assured by pharmacological strategies and, when contraindicated, by non pharmacological measures, such as early mobilization, graduated compression stockings (GCS), intermittent pneumatic compression (IPC) or inferior vena caval filters. Literature evidence on non pharmacological VTE prophylaxis lacks and guidelines are not standardized for hospitalized ill medical patients. Much recently randomized clinical trials in patients with stroke and other medical diseases, seem to increase doubts and reduce certainties in this context. In this review we provide information about non pharmacological thromboprophylaxis in acutely hospitalized ill medical patients.