Clinical observation on intermittent pneumatic compression and low-molecular-weight heparin in the prevention of lower extremity deep venous thrombosis in medical ICU patients with high risk

Objective To explore the safety and effect of intermittent pneumatic compression(IPC) and low-molecular-weight heparin(LMWH) in the prevention of lower extremity deep venous thrombosis(DVT) medical ICU patients with high risk.

Methods A total of 100 medical ICU patients with high-risk venous thromboembolism were selected and randomly divided into 4 groups: IPC group, LMWH group, IPC+LMWH group and control group.Before treatment and on the first day, the fourth day, and the seventh day after the treatment, the patients were tested with the color Doppler examination to determine the blood flow velocity of popliteal vein and femoral vein, and the thrombus was detected.Simultaneously, activated partial thromboplastin time (APTT) and thromboelastogram were detected.The number of lower extremity DVT and adverse events in each group were compared.

Results There was no significant difference in the indexes of APTT, thromboelastogram between each treatment group and the control group before treatment (P>0.05), there was no significant difference in the indexes of APTT, thromboelastogram in each group between after treatment and before treatment(P>0.05), and there was no significant difference in the indexes of APTT, thromboelastogram between each treatment group and the control group after treatment (P>0.05).There was no significant difference in mean blood flow velocity of popliteal vein and femoral vein in each group before treatment(P>0.05).After treatment, the mean blood flow velocity in IPC group and IPC+LMWH group was faster than that in control group(P < 0.01).The mean blood flow velocity in IPC group and IPC+LMWH group was faster than that before treatment (P < 0.05).There were 2 cases (8%) of lower extremity DVT in IPC group, 2 cases(8%) of lower extremity DVT in LMWH group, 1 case(4%) of lower extremity DVT in IPC+LMWH group, 8 cases (32%) of lower extremity DVT in control group, the incidence of DVT in each treatment group was lower than that in control group(P < 0.05 to P < 0.01), bleeding adverse reaction did not happen in each group during treatment.

Conclusions IPC and LMWH are safe and effective methods to prevent lower extremity DVT in high-risk patients.