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1、IPC预防术后静脉淤滞与DVTIntermittentsequentialpneumaticcompressionofthelegsinthepreventionofvenousstasisandpostoperativedeepvenousthrombosisA.N.Nicolaides,M.S.,F.R.C.S.,F.R.C.S.E.,J.FernandeseFernandes,M.D.,andA.V.Pollock,F.R.C.S.,LondonandScarborough,EnglandTheoptimalst
2、imuluswhichproducedthemaximumincreaseinbloodvelocityinthefemoralveinduringcompressionofthetowerlimbwithasequentialcompressiondevice(sixchambers)wasdeterminedusingDopplerultrasoundin10normallimbs.Pressuresof35,30,and20mmHgattheankle,calf,andthigh,respectively,app
3、liedsequentiallyfor12secondsproduceda240%increaseinthepeakbloodvelocity.Higherpressuresdidnotincreasevelocityanyfurther.Anonsequentialdevice(onechamber)inflatedat35mmHgfor12secondsproducedonlya180%increaseinbloodvelocity.Theefficacyofthesequentialdevicetoprevent
4、deepvenousthrombosisthenwastestedandcomparedwithasinglechamberdeviceandsmall-dosesubcutaneousheparininarandomized,controlledclinicaltrialusingthe125l-fibrinogentest.Theresultssuggestthatthesequentialcompressiondeviceisaseffectiveasheparinduringtheperiodwhenitisu
5、sed(thefirst24hoursafteroperation)andmoreeffectivethananonsequentialdeviceinpreventingdeepvenousthrombosisproximaltothecalf.FromtheAcademicSurgicalUnit,VascularLaboratory,St.Mary'sHospitalMedicalSchool,London,andtheDepartmentofSurgery,ScarboroughHospital,Scarbor
6、ough,EnglandTHEINCIDENCEofpostoperativedeepvenousthromtx)siscanbereducedeitherbymethodswhichpreventthehypercoagulableStatewhichoccursaftertissuetraumaorbymethodswhichpreventvenousstasis.9Althoughtheformerareeffective,theycarryasmallbutdefiniterisk.8Morbidityhasn
7、otbeendemonstratedwithintermittentpneumaticcompressionofthelegs,whichhasreducedtheincidenceofdeepvenousthrombosisby60%to82%inthreecontrolledstudiesinwhichthelegswerescannedwiththe125I-fibrinogentestforIweek4,12,14andabolishedthrombosisinanotherinwhichthelegswere
8、scannedfor3daysonly.Thepneumaticleggingsintheabovestudieswereofasinglechamberdesign,exertinguniformpres-sureonthelegsfromankletoknee.Thepreventionofstasisbyintermitte
