Effects of heated medical elastic stockings on the prevention of deep venous thrombosis and hypothermia of lower limbs during posterior lumbar intervertebral fusion

Abstract

Objective To develop a kind of heated medical elastic stockings to prevent the occurrence of deep vein thrombosis (DVT) and hypothermia in patients with lumbar degenerative diseases undergoing posterior lumbar intervertebral fusion (PLIF) . Methods A total of 180 patients with lumbar degenerative diseases undergoing PLIF from February 2015 to August 2017 were selected by purposive sampling method, and divided into routine group (group A) , normal elastic stockings (group B) , heated medical elastic stockings (group C) according to the sequence of operation time, with 60 cases in each group. On the premise of routine thermal protection measures and DVT basic preventive measures, group A did not wear stretch socks, group B wore normal elastic stockings, and group C wore heated medical elastic stockings. Patients in the group B and C were treated with normal and heated stretch stockings during anesthesia preparation 1 hour prior to surgery. The incidence rate of lower extremity DVT and hypothermia in each group was calculated by monitoring deep veins blood flow velocity of both lower limbs, D-dimer, foot temperature and the core temperature at each time node during the operation. Results In group C: left femoral superficial vein velocity was (17.47±3.07) cm/s; right femoral superficial vein velocity was (16.95±3.25) cm/s; left popliteal vein blood flow velocity was (16.03±3.37) cm/s; right popliteal vein blood flow velocity was (16.37±3.39) cm/s. All the results above were higher than those in group A and B (P<0.01) . The D-dimer were (587±129) μg/L at the end of surgery and (392±119) μg/L 24 h after surgery in group C, which were significantly lower than group A and B (P<0.01) . The incidence of DVT at the end of operation and 24 hour postoperation in group A was 8.3% and 15.0%, while 5.0% and 5.0% in group B respectively. There was no DVT occurrence in group C at the two time points, and the difference was statistically significant (P<0.01) . Comparing foot temperature and core temperature of each time point, it was significantly higher in group C than group A and B (P<0.05) . There were 8 cases of hypothermia in group C, and the incidence rate was 12.5%, which were both significantly lower than that in group A (56.7%) and group B (40.0%) (P<0.01) . Conclusions The heated elastic stockings can effectively reduce the risk of DVT and hypothermia in the patients with lumbar degenerative diseases undergoing PLIF and can be popularized in clinical practice. Key words: Venous thrombosis; Compression stockings; Hypothermia; Prevention