间歇性充气加压治疗在预防静脉血栓形成效果的Meta分析
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王海燕, Email: 1604143153@qq .com

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Efficacy of intermittent pneumatic compression therapy in venous thrombosis prevention: a Meta-analysis
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    摘要:

    目的:评价间歇性充气加压(IPC)治疗在预防静脉血栓形成的效果。 方法:检索中外文数据库所有关于IPC治疗来预防静脉血栓形成的随机对照试验(RCT)。按照纳入、排除标准纳入文献,并采用RevMan 5.2软件Meta分析。 结果:最终纳入63个RCT,共15 444例患者。Meta分析结果显示,与无干预组比较,IPC治疗组深静脉血栓(DVT)的发生率(OR=0.34,95% CI=0.26~0.45,P<0.00001)和肺栓塞(PE)的发生率(OR=0.45,95% CI=0.31~0.65,P<0.0001)明显减少;与压力循环袜(TEDS)治疗组比较,IPC组DVT的发生率(OR=0.55,95% CI=0.35~0.88,P=0.00001)明显减少;与抗凝药物治疗组比较,IPC组在预防DVT方面无优势(OR=1.05,95% CI=0.69~1.59,P=0.82),但出血风险(OR=0.31,95% CI=0.19~0.50,P<0.00001)明显降低。 结论:在预防住院患者静脉血栓方面,IPC治疗具有明显的疗效,且无抗凝药物治疗所带来的出血风险。

    Abstract:

    Objective: To evaluate the efficacy of intermittent pneumatic compression (IPC) therapy in thromboprophylaxis. Methods: The randomized controlled trials (RCTs) concerning IPC therapy for thromboprophylaxis were searched from several national and international databases. Meta-analysis was performed by using RevMan 5.2 software after a literature screen for inclusion and exclusion criteria. Results: Sixty-three RCTs were finally selected, with a total of 15 444 patients. Results of Meta-analysis showed that in IPC treatment group, the incidence of deep venous thrombosis (DVT) and pulmonary embolism (PE) were significantly decreased compared with non-intervention group (OR=0.34, 95% CI=0.26–0.45, P<0.00001; OR=0.45, 95% CI=0.31–0.65, P<0.0001); the incidence of DVT was significantly decreased compared with group of treatment with thigh-length thromboembolic deterrent stockings (TEDS) (OR=0.55, 95% CI=0.35–0.88, P=0.00001). Compared with the group treated with anticoagulant therapy, IPC treatment had no superiority in thromboprophylaxis (OR=1.05, 95% CI=0.69–1.59, P=0.82), but the risk of bleeding was significantly reduced (OR=0.31, 95% CI=0.19–0.50, P<0.00001). Conclusion: IPC therapy has demonstrable efficacy in prevention of venous thrombosis in hospitalized patients and does not have the risk of bleeding caused by anticoagulant drugs.

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古丽加瓦尔,马婷,巴合提·卡力甫,王海燕.间歇性充气加压治疗在预防静脉血栓形成效果的Meta分析[J].中国普通外科杂志,2014,23(6):797-806.
DOI:10.7659/j. issn.1005-6947.2014.06.018

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  • 收稿日期:2014-02-28
  • 最后修改日期:2014-05-04
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  • 在线发布日期: 2014-06-15