Effect of the beginning time of intermittent pneumatic compression on hemodynamic and deep vein thrombosis of patients with major orthopedic surgery / 中国实用护理杂志

ABSTRACT

Objective:To investigate the effects of beginning time of intermittent pneumatic compression (IPC) on hemodynamics and deep vein thrombosis (DVT) of patients with major orthopedic surgery.Methods:A total of 99 patients who underwent major orthopaedic surgery in the Department of Orthopaedics, West China Hospital, Sichuan University from January 2018 to December 2019 were selected as the research objects, which were assigned to ultra-early group, early group and control group, each group contained 33 cases. The IPC were used 3 days before surgery in the ultra-early group, 1 day before surgery in the early group, and after surgery in control group. The incidence of DVT and deep skin pressure injury within 14 days was observed, the blood flow velocity of deep femoral vein and plasma D-dimer in the three groups were also compared.Results:There was no significant difference in the incidence of DVT among the three groups ( P> 0.05), however, the deep tissue injury rate was 18.18% (6/33) in the ultra-early group, significantly higher than 3.03% (1/33) in the early group and 0 in control group, the difference was statistically significant ( χ2 value was 9.531, P<0.05). After 1 day and 3, 5, 7 days of surgery, the blood flow velocity of deep femoral vein in the ultra-early group and the early group were (26.48±2.24), (25.79±2.18), (26.67±3.74), (25.88±2.83) ml/s and (25.76±1.87), (25.39±1.98), (25.45±2.93), (25.48±3.75) ml/s, significantly higher than (23.39±1.75), (23.73±2.61), (23.79±2.30), (22.21±4.42) ml/s in the control group, the difference was statistically significant ( F values were 7.428-22.350, P<0.01). After 3, 5, 7 days of surgery, the levels of plasma D-dimer in the ultra-early group and the early group were (1.11±0.26), (1.03±0.23), (0.98±0.28) mg/L and (1.18±0.32), (1.12±0.24), (1.05±0.31) mg/L, significantly lower than (1.38±0.40), (1.32±0.39), (1.20±0.26) mg/L in the control group, the difference was statistically significant ( F values were 5.809, 8.442, 4.962, P<0.01). Conclusion:Using IPC one day before operation can significantly increase the blood flow velocity of deep femoral vein, reduce the level of plasma D-dimer, and do not increase the incidence of deep skin pressure injury in patients with major orthopedic surgery.