间歇性对大腿加高气压一种预防DVT的新方法.doc

间歇性对大腿加高气压：一种预防DVT的新方法 Intermittent Sequential High-Pressure Compression of the Leg A New Method of Preventing Deep Vein Thrombosis Erich Muhe, MD, FACS, Boblingen, West Germany Recently, a number of studies have reported very good results obtained with a new physical method of preventing deep vein thrombosis--pneumatic leg compression [1-11]. For intermittent pneumatic leg compression, inflatable flexible plastic boots are slipped over both legs. Thus far, pneumatic compression of these boots has been performed with a maximum pressure peak of 55 mm Hg over a period of about 12 seconds. This empties the venous pool in the leg. After about 60 seconds with no external pressure applied, during which the venous system fills up again, the next compression cycle follows. Our objective was to study whether pneumatic compression with higher pressures would increase the venous flow velocity. The tests were performed in patients confined to bed to see whether the number of deep vein thromboses of the leg could be reduced by the use of higher pressures. Material and Methods Venous flow velocity at different pneumatic pressures: We chose 25 patients from our department who were informed about the purpose and method of our study. They included 13 women and 12 men between the ages of 45 and 81 years. Patient selection was randomized. We used the TED Sequential Compression Device~, model 5315 for sequential intermittent compression (supplied by the Kendall Company, Chicago, IL; in West Germany, Neustadt/Danube) (Figure 1). For our studies, all units had been adjusted and recalibrated by the Kendall research center, to cover the range of 0 to 100 mm Hg continuously. For compression of the leg, we employed inflatable plastic boots which extended from the ankle to the proximal thigh (also supplied by Kendall). Each boot consists of three chambers, two at the calf and one at the thigh: Each compression wave propagates sequentially from the ankle up to the th