Intermittent pneumatic compression を用いた消化器手術後の深部静脈血栓症・肺塞栓症の予防

Abstract

Postoperative pulmonary embolism (PE) is a serious complication that has a high mortality rate. The majority of emboli are derived from deep vein thrombosis (DVT). Because the incidence of postoperative DVT and PE in Japan is low, prophylaxis for DVT and PE is not a common procedure. We have assessed the risk of DVT and PE using a preoperative original risk score system, and adapted Intermittent Pneumatic Compression (IPC) for all surgical patients since Dec. 1998. We compared the frequency of postoperative DVT and PE between the 109 patients treated without IPC who were operated on between August 1997 and November 1998 (non-IPC group) and the 216 patients treated with IPC who were operated on between December 1998 and March 2001 (IPC group). In the non-IPC group, four patients suffered from DVT or PE (3.7%), while only one patient experienced a PE attack in the IPC group (0.5%). This difference was statistically significant (p=0.045, Fisher's exact test). Logistic analysis revealed that IPC decreased the risk of DVT or PE tenth. No side effects of IPC were experienced. As two patients with mean or low risk scores developed DVT or PE, it was difficult to predict the occurrence of DVT and PE. IPC is an effective prophylaxis for DVT and PE and is both safe and easy to perform. Thus, IPC should be performed in all opertive patients.