DOI QR코드

DOI QR Code

A study on the Prevention of Deep Vein Thrombosis and Skin Response of Patients after Intracranial Surgery : By Boots and Calf Intermittent Pneumatic Compression Device

뇌수술 환자의 심부정맥혈전증 예방과 피부반응에 미치는 실험연구 : 부츠형과 무릎형의 간헐적 공기 압박기 적용에 따라

  • Received : 2016.04.01
  • Accepted : 2016.05.12
  • Published : 2016.05.31

Abstract

This study examined the prevention of deep vein thrombosis and skin response after the application of boots or calf intermittent pneumatic compression (IPC) devices in immobile patients with intracranial surgery. The subjects of this study included 60 patients in a surgical intensive care unit after receiving intracranial surgery from May to November in 2015. The blood flow velocity was measured daily to assess the deep vein thrombosis for 7 days, and the skin response of the legs was observed regularly. As a result, the boots IPC group showed an increased blood flow velocity over time compared to the calf IPC group. A significant statistical difference was observed in both the boots IPC group and calf IPC group over time (Right side; F=64.41, p<.001, Left side; F=58.21, p<.001). The dorsum circumference over time and the correlations between two groups (Right side; F=9.13, p <.001, left side; F=9.29, p<.001) also showed a significant difference. In addition, the boots IPC group showed no skin complications. In conclusion, the boots type IPC is a more effective method for preventing deep vein thrombosis for immobile patients with intracranial surgery.

본 연구는 뇌수술 후 부동 환자에게 부츠형 또는 무릎형 간헐적 공기 압박기 적용 후 심부정맥 혈전증 예방과 피부반응에 미치는 영향을 평가하기 위한 실험연구이다. 연구대상은 2015년 5월 부터 11월 까지 뇌수술 후 외과계 중환자실에 입실한 60명을 대상으로 하였다. 심부정맥 혈전증 평가는 7일 동안 대퇴정맥 혈류속도의 변화를 매일 측정하였고 피부 반응 정도도 매일 규칙적으로 관찰하였다. 그 결과 부츠형 간헐적 공기 압박기 적용군이 무릎형 간헐적 공기압박기 적용군보다 시간이 경과함에 따라 대퇴정맥 혈류속도가 증가함을 확인하였다. 즉, 7일 동안 측정한 평균 대퇴정맥 혈류속도는 시간경과에 따른 측정시기 오른쪽(F=64.41, p <.001), 왼쪽(F=58.21, p <.001)모두 통계적으로 유의한 차이를 나타내었다. 두 군 간의 발등 둘레는 측정시기와 집단 간의 상호작용에서 오른쪽(F=9.13, p <.001), 왼쪽(F=9.29, p<.001) 모두 통계적으로 유의한 차이를 보였다. 또한 부츠형 간혈적 공기 압박기 적용군은 피부 합병증도 발생하지 않았다. 이러한 결과는 뇌수술 후 부동환자에게 부츠형 간헐적 공기 압박기 적용이 심부정맥 혈전증을 예방하는데 보다 효과적임을 알 수 있다.

Keywords

References

  1. K. Yamashita, T. Yokoyama, N. Kitaoka, T. Nishiyama, M. Manabe, "Blood flow velocity of the femoral vein with foot exercise compared to pneumatic foot compression", Journal of clinical anesthesia, 17, pp.102-105, 2005. DOI: http://dx.doi.org/10.1016/j.jclinane.2004.05.007
  2. R.E. Iverson, J.L. Gomez, "Deep venous thrombosis: Prevention and management", Clinics in Plastic Surgery, 40(3), pp. 389-398. 2013. DOI: http://dx.doi.org/10.1016/j.cps.2013.04.002
  3. M. J. Jang, S. M. Bang, D. Oh, Incidence of venous thromboembolism in Korea: From the Health insurance review and assessment service database, 9(1), pp.85-91, 2011. https://doi.org/10.1111/j.1538-7836.2010.04108.x
  4. D. E. Golan, A. H. Tashjian, E. J. Armstrong, A W. Armstrong, "Principles of pharmacology: The pathophysiologic basis of drug therapy", 3rd ed. Philadelphia, PA: Lippincott Williams & Wilkins, 2011.
  5. K.Y. Song, "Prevention and treatment of venous thromboembolism (VTE) in cancer patients", Korean Journal of Clinical Oncology, 5(2), pp.32-40,2009. DOI: http://dx.doi.org/10.14216/kjco.09012
  6. Korean Society of Thrombosis and Hemostasis. Japan venous prevention recommendations-some modifications according to local real one. Available at http://www.thrombo.or.kr [accessed on 2 March, 2013.
  7. E. Elpern, K. Killeen, G. Patel, P. A. Senecal, "The application of intermittent pneumatic compression devices for thromboprophylaxis: An observational study found frequent errors in the application of these mechanical devices in ICUs", American Journal of Nursing, 113(4), pp.30-36, 2013. DOI: http://dx.doi.org/10.1097/01.NAJ.0000428736.48428.10
  8. J. S. Kim, H. J. Kim, Y.H. Woo, J. Y. Lym, C. H. Lee, "Effects on changes in femoral vein blood flow velocity with the use of lower extremity compression for critical patients with brain injury", Journal of Korean Academic Nursing, 39(2), pp.288-297, 2009. DOI: http://dx.doi.org/10.4040/jkan.2009.39.2.288
  9. C. K. Hong, H. S. Kim, J. Y. Kim, K. S. Kwak, O. M. Cho, H. Y. Cha, S. H. Lim, Y. J. Song, "Risk factors and incidence of deep vein thrombosis in lower extremities among critically ill patients", Journal of Clinical Nursing, 21, pp.1840-6, 2012. DOI: http://dx.doi.org/10.1111/j.1365-2702.2012.04112.x
  10. J. Y. Choi, S. J. Park, "A comparison of interventions recorded in nursing notes between acute and subacute stage after a cerebrovascular accident", Journal of Korean Academy of Nursing, 36, pp.227-235, 2006. https://doi.org/10.4040/jkan.2006.36.2.227
  11. K. Lacut, L. Bressollette, G. Le Gal, E. De Etienne, A. Tinteniac, A. Renault, F. Rouhart; G. Besson; JF. Garcia, D. Mottier, E. Oger, "Prevention of venous thrombosis in patients with acute intracerebral hemorrhage", Neurology, 65, pp.865-869, 2005. DOI: http://dx.doi.org/10.1212/01.wnl.0000176073.80532.a2
  12. J. S. Yun , E. O. Kim, H. J. Park, K. H. Park, Y. S Seo, L. Y. Kim, Y. H. Kim, "Knee versus Thigh Length Anti-embolic Stockings for Prevention of Deep Vein Thrombosis in Postoperative Surgical Patients: Evidence-based Practice Implementation", Evidence and Nursing, 1(1), pp.25-32, 2013.
  13. S. J. Yim, S.C. Woo, I. W. Byun, "The Effects of Foot Pump on Prevention of Deep Vein Thrombosis Following Total Knee Arthroplasty", Knee Surgery & Related Research, 19(2), pp.135-141, 2007.
  14. M. Dennis, P. Sandercock, C. Graham, J. Forbes, G. Murray, "Effectiveness of intermittent pneumatic compression in reduction of risk of deep vein thrombosis in patients who have had a stroke (CLOTS 3): a multicentre randomized controlled trial", Lance, 383, pp.516-524, 2013.
  15. C. Zhang, W. Zeng, H. Zhou, B. X. Zheng, J. C. Cheng, X. Y .Li, Y. P. Jiang, L. D. Jiang, X.J. Li, "The efficacy of intermittent pneumatic compression in the prevention of venous thromboembolism in medical critically ill patients", Chinese Critical Care Medicine, 23(9), pp.563-565, 2011. DOI: http://dx.doi.org/10.1097/SLA.0b013e3181b5d61c
  16. R. J. Morris, J. P. Woodcock, "Intermittent pneumatic compression or graduated compression stockings for deep vein thrombosis prophylaxis?: A systematic review of direct clinical comparisons", Annals of Surgery, 251(3), pp.393-396, 2010. DOI: http://dx.doi.org/10.1097/SLA.0b013e3181b5d61c
  17. J. Urbankova, R. Quiroz, N. Kucher, S. Z. Goldhaber, "Intermittent pneumatic compression and deep vein thrombosis prevention: A meta-analysis in postoperative patients", Thrombosis and Haemostasis, 94(6), pp.1181-1185, 2005. DOI: http://dx.doi.org/10.1160/th05-04-0222
  18. H. S. Kim, O. M. Cho, J. S. Kim, H. O. Jang, Y. K. Kim, S. H. Kim, H. N. Min, K. K. Sun, K. C. Hong, J. Y. Kim, J. H. Chung, "Prevention Effects of Graduated Compression Stockings and Intermittent Pneumatic Compression on Deep Vein Thrombosis in SICU Patients: Pilot Study", Journal of Korean Academy of Fundamentals Nursing, 22(30), pp.249-257, 2015. DOI: http://dx.doi.org/10.7739/jkafn.2015.22.3.249
  19. S. A. Yablon, W. A. Jr. Rock, T G. Nick, M, Sherer, C. M. McGrath, K. H. Goodson "Deep vein thrombosis: Prevalence and risk factors in rehabilitation admissions with brain injury", Neurology, 63, pp.485-491, 2004. DOI: http://dx.doi.org/10.1212/01.WNL.0000133009.24727.9F
  20. AORN Guideline for Prevention of Venous Stasis, AORN Journal, 85(3), pp.607-624, 2007. DOI: http://dx.doi.org/10.1016/S0001-2092(07)60131-8
  21. S.L. Keith, D. J. McLaughlin, F. A Jr. Anderson, C. E. Jones, M. J. Rohrer, B. S. Cutler, "Do gtsduated compression stockings and pneumatic boots have an additive effect on the peak velocity of venous blood flow?, Archives of Surgery, 127(6), pp.727-730, 1992. DOI: http://dx.doi.org/10.1001/archsurg.1992.01420060107016
  22. H. Iwama, S. Obara, H. Ohmizo, Changes in femoral vein blood flow velocity by intermittent pneumatic compression: calf compression device versus plantar-calf sequential compression device", Journal of Anesthesia, 18(3), pp.232-233, 2004. DOI: http://dx.doi.org/10.1007/s00540-004-0241-9
  23. D. Hoefnagel, L. E. Kwee, E.HpP. van Putten, J. M. Kros, C. M. F. Dirven, R. Dammers, "The incidence of postoperative thromboembolic complications following surgical resection of intracranial meningioma. A retrospective study of a large single center patient cohort, Clinical Neurology and Neurosurgery, 123, pp.150-154, 2014. DOI: http://dx.doi.org/10.1016/j.clineuro.2014.06.001
  24. Y. M. Arabi, M. Khedr, S. I. Dara, G. S. Dhar, S. A. Bhat, H. M. Tamim, L.Y. Afesh, "Use of intermittent pneumatic compression and not graduated compression stockings is associated with lower incident VTE in critically ill patients: A multiple propensity scores adjusted analysis" Chest, 144(1), pp.152-159, 2013. DOI: http://dx.doi.org/10.1378/chest.12-2028
  25. J. M. Zhao, M. L. He, Z. M.Xiao, T. S. Li, H. Wu, H. Jiang, M. Fujisawa, "Different types of intermittent pneumatic compression devices for preventing venous thromboembolism in patients after total hip replacement (Review), The Cochrane Library, Issue 1, pp.1-20, 2012. DOI: http://dx.doi.org/10.1002/14651858.cd009543.pub2
  26. M. Fujisawa, M. Naito, I. Asayama, T. Kambe, K. Koga, "Effect of calf-thigh intermittent pneumatic compression device after total hip arthroplasty: Comparative analysis with plantar compression on the effectiveness of reducing thrombogenesis and leg swelling", Journal of Orthopaedic Science, 8(6), pp.807-11, 2003. DOI: http://dx.doi.org/10.1007/s00776-003-0706-y
  27. S. B. Johnson, "Methodological issues in diabetes research: Measuring adherence", Diabetes Care, 15(11), 1658-1667, 1992. DOI: http://dx.doi.org/10.2337/diacare.15.11.1658