Abstract：
Whether intermittent pneumatic compression (IPC) is a more effective form of thromboprophylaxis than anticoagulants in individuals undergoing neurosurgery remains controversial. Relevant studies are sparse and inconsistent. Therefore, direct comparisons are difficult to perform and impractical. Hence, we summarized and compared the efficacy and safety of IPC and anticoagulants for the prevention of venous thromboembolism (VTE) in adults undergoing cranial or spinal procedures. Several electronic databases were searched for randomized controlled trials on the use of IPC and anticoagulants for thromboembolism prevention in neurosurgical patients, from inception to August 6, 2019. Studies reporting the selected endpoints were included in direct and Bayesian network meta-analyses to estimate the relative effects of the interventions. Overall, our analysis included 18 trials comprising 2474 patients. Both IPC (RR, 0.41; 95% CrI, 0.26-0.60) and chemical prophylaxis (RR, 0.48; 95% CrI, 0.28-0.68) were found to be more efficacious than the placebo in reducing the risk of deep vein thrombosis (DVT). In addition, our analysis also demonstrated that both IPC (RR, 0.10; 95% CrI, 0.01-0.60) and chemical prophylaxis (RR, 0.31; 95% CrI, 0.05-1.00) reduced the risk of pulmonary embolism (PE) significantly more than the placebo. Based on the available evidence of moderate-to-good quality, IPC is equivalent to anticoagulants for thromboprophylaxis in terms of efficacy. Evidence to support or negate the use of pharmacological prophylaxis in terms of safety is lacking. The results of ongoing and future large randomized clinical trials are needed.
摘要：
在接受神经外科手术的个体中，间歇性充气压缩（IPC）是否是比抗凝血剂更有效的血栓预防形式仍存在争议。相关研究稀疏且不一致。因此,直接比较难以执行且不切实际。因此，我们总结并比较了IPC和抗凝剂在接受颅脑或脊柱手术的成人中预防静脉血栓栓塞(VTE)的有效性和安全性.搜索了几个电子数据库，用于神经外科患者使用IPC和抗凝剂预防血栓栓塞的随机对照试验。从成立到2019年8月6日。报告选定终点的研究包括在直接和贝叶斯网络荟萃分析中，以估计干预措施的相对效果。总的来说,我们的分析包括18项试验,包括2,474例患者.两个IPC(RR，0.41;95%CrI,0.26-0.60)和化学预防(RR，0.48;95%CrI,发现0.28-0.68）在降低深静脉血栓形成（DVT）的风险方面比安慰剂更有效。此外,我们的分析还表明，两个IPC(RR，0.10;95%CrI,0.01-0.60)和化学预防(RR，0.31;95%CrI,0.05-1.00）比安慰剂显着降低了肺栓塞（PE）的风险。根据现有的中等质量到良好质量的证据，IPC在疗效方面等同于用于血栓预防的抗凝剂。缺乏在安全性方面支持或否定使用药物预防的证据。需要正在进行和未来的大型随机临床试验的结果。
