暂无摘要。

This meta-analysis assessed the effect of pneumatic compression therapy on the wound healing of venous ulcers, with the aim of providing a basis for the selection of clinical treatment. Randomised controlled trials (RCTs) on the application of pneumatic compression therapy to venous ulcers were collected by searching PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, VIP, and Wanfang databases, with a timeframe from database inception to August 2023. After two researchers independently screened the literature, extracted information, and evaluated the quality of the included studies, a meta-analysis was performed using RevMan 5.4 software. Six RCTs with 367 patients were included, with 172 patients in the intervention group and 195 in the control group. The results showed that pneumatic and bandage compression therapies had a similar impact on wound healing rates of venous ulcers (54.65% vs. 53.84%, odds ratio [OR]: 1.02, 95% confidence interval [CI]: 0.49-2.12, p = 0.96), changes in wound area (standardised mean difference: -0.16, 95% CIs: -0.45 to 0.12, p = 0.26), adverse event rates (76.56% vs. 67.07%, OR: 1.62, 95% CI: 0.77-3.39, p = 0.20), and the differences were not statistically significant. Thus, current evidence suggests that the effects of pneumatic compression therapy on wound healing rates, changes in wound area, and the incidence of adverse events in patients with venous ulcers are similar to those of bandage pressure therapy. However, owing to the limitations in the number and quality of studies, more high-quality RCTs are needed to clarify the feasibility and economics of pneumatic compression therapy in patients with venous ulcers.

Intermittent pneumatic compression (IPC) therapy has been adopted in prevention and treatment of ischemic-related peripheral vascular diseases. The aim of this study is to provide an approach to personalize the compression strategy of IPC therapy for maximizing foot skin blood flow. In this study, we presented a method to predict the optimized compression mode (OCM) for each subject based on biomechanical features extracted from experimental data tested with multiple IPC modes. First, to demonstrate the blood flow enhancing effect by applying the personalized OCM, four IPC modes of different frequency settings were tested on a total of 24 subjects. The frequency settings were adjusted by deflating-waiting time, which was defined as the total time length from the start of cuff deflation to the start of next compression. The foot skin blood perfusion and IPC air cuff pressure were monitored during the experiments. The personalized OCM was defined as the certain IPC mode that has the highest blood perfusion augmentation (BPA). Compared with the rest stage blood perfusion, the personalized OCM settings resulted in >50% of augmentation for 75% of healthy subjects (maximum augmentation at 244%) and >20% augmentation for 75% of patients with diabetes (maximum augmentation at 180%). Second, for predicting the OCM, we establish a random forest model based on the features extracted from the experimental data. The binary classification resulted in acceptable prediction performance (AUC > 0.7). This study might inspire new IPC strategies for improving foot microcirculation.

Deep vein thrombosis (DVT) is common in the lithotomy position after laparoscopic surgery. Intermittent pneumatic compression (IPC) plays an important role in DVT prevention. However, few studies have compared the different compression areas of IPC application. It was hypothesized that the location of the compression sleeves could have an impact on the effects of thromboprophylaxis.
In this randomized, controlled trial performed from August 2020 to March 2021, 164 patients scheduled to undergo laparoscopic Dixon surgery were randomly assigned to one of four groups, based on the bilateral placement of compression sleeves during surgery: feet, calves, thighs, or control (no IPC). Both lower extremities were monitored for DVT on days 1 and 7 after surgery, using ultrasonographic assessment of mean blood velocity, blood flow volume, and diameter of the common femoral veins. Thrombosis-related hematologic analysis was performed.
On day 1 after surgery, IPC of the feet or calves was associated with a reduced prevalence of DVT compared with controls (both: P = 0.024; OR = 0.09; 95% CI, 0.01-0.72), while IPC of the thighs had no significant benefit (P = 0.781; OR = 0.86; 95% CI, 0.29-2.55). The prevalence of DVT in the left extremity was lower with IPC of the feet and calves compared with controls (both, P = 0.048). The mean blood velocity in the common femoral vein was significantly increased after surgery with IPC of the left and right feet (P = 0.006 and 0.007, respectively) and calves (P = 0.011 and P = 0.026, respectively) compared with controls. Similarly, the volume of blood flow in the left common femoral vein was greater with IPC of the feet and calves (P = 0.03 and 0.027, respectively). However, on day 7 after surgery, the between-group differences in the prevalences of DVT and hematologic indicators of thrombosis were not significant.
On day 1 after surgery, IPC application at the feet or calves facilitated venous return and, hence, reduced the prevalence of DVT, especially in the left extremities. However, there were no significant differences in the prevalences of DVT or thrombosis-related hematologic indicators among the four groups on the day 7 after surgery. Chinese Clinical Trial Registration identifier: ChiCTR2000035325.

Intermittent pneumatic compression (IPC) therapy has been used to enhance peripheral blood flow for prevention and rehabilitation of ischemic-related vascular diseases. A novel phenomenon has been reported that multiple blood flow surges appeared in the skin blood flow signal during each compression, but its mechanism has not been fully revealed. This study aimed to gain insights into the origins of these blood flow surges through experiment and biomechanical modeling methods. Foot skin blood flow (SBF) signals of 13 healthy adults (23.8 ± 0.5 yr old, 7 males) and air cuff pressure signals were recorded during IPC. Lumped parameter modeling and wavelet analysis were adopted to investigate the multiple blood flow surges (named as Peak1, Peak2 and Peak3). The results of the simulated Peak1 and Peak2 were in good agreements with the experiment results, suggesting that IPC could enhance foot SBF not only by deflation, but also by inflation. Statistical analysis demonstrated that high frequency compression with more frequent occurrence of Peak1 and Peak2 lead to significantly higher (Friedman test, p < 0.001) time-averaged SBF enhancement than the traditional mode. In addition, wavelet analysis showed that the major frequency component of the Peak3 (0.059 Hz) was within the range of the vascular myogenic activity, suggesting a vascular regulation process triggered by intravascular pressure changes. Our study provide new insights into the mechanism of how IPC enhance foot SBF.

To investigate the effect of intermittent pneumatic compression (IPC) combined with rehabilitation training on patients with acute cerebral infarction and motor impairment, seventy-four patients with acute cerebral infarction and hemiplegia were randomly and equally divided into two groups, the control group and the IPC treatment group. The patients in the control group received conventional drug therapy and rehabilitation training, and the patients in the treatment group received the IPC treatment in addition to the treatment given in the control group. Motor function, the primary outcome, of the two groups was evaluated by Fugl-Meyer motor function scores. The Barthel index assessment scale was used to evaluate the ability to perform activities of daily living of the two groups, as a secondary outcome. All these indicators were collected and compared before treatment and at 7 days, 14 days, and 30 days after treatment. The incidence of adverse reactions associated with treatment was also recorded. At 7, 14, and 30 days after treatment, the Fugl-Meyer scores (27.16 ± 7.37, 33.41 ± 7.16 and 38.72 ± 7.65) and Barthel scores (47.16 ± 7.37, 52.41 ± 7.16, and 56.09 ± 8.32) of the treatment group were also significantly higher than those (23.65 ± 3.11, 26.13 ± 3.25, and 28.75 ± 5.92; 44.15 ± 3.11, 46.63 ± 3.25 and 47.75 ± 4.22) of the control group (all P < 0.05). With the extension of follow-up time, both scores were higher. There were no treatment-related adverse events in either of the two groups of patients during or after treatment. In conclusion, the IPC combined with rehabilitation training can effectively improve motor function deficits, the ability to perform activities of daily living, and quality of life for patients.

BACKGROUND The 2009 China Intensive Care Units (ICU) prevention guidelines lack venous thromboembolism (VTE) risk assessment. This survey was conducted to assess the risk of VTE, develop and establish a diagnosis, and provide prevention and treatment guidelines for ICU VTE. MATERIAL AND METHODS A cross-sectional questionnaire survey of ICU doctors ICUs was conducted online in the tertiary and secondary hospitals of Zhejiang province in China. The questionnaire included VTE-related hospital hardware information, VTE awareness, knowledge, and monitoring system. RESULTS The risk assessment rates at the time of admission and changed disease condition were 67.7% and 60.4%, respectively. D-dimer and ultrasound were commonly used for VTE screening. Heparin is preferred for short-term intravenous anticoagulant therapy, and warfarin is preferred for long-term therapy. We found that 23.53% of the ICUs have bedside ultrasound and staff for ultrasound examination, and 59.4% of the hospitals are equipped with VTE monitoring information systems. The VTE early identification specification is the key to whether the VTE assessment is performed after the patient enters the ICU. CONCLUSIONS The survey assessed the VTE risk and key VTE management elements. However, high heterogeneities were detected in the assessment. The ICU doctors have relatively limited awareness of VTE. Thus, there is an urgent need to update and standardize the ICU VTE guidelines for the prevention and treatment of VTE in China.

This study assessed the effect of adjunctive intermittent pneumatic compression (IPC) on venous thromboembolism incidence in hospitalized patients receiving pharmacologic thromboprophylaxis.
We searched Medline, Embase, and the Cochrane Central Register with no language restrictions from inception until May 15, 2019, for randomized clinical trials comparing adjunctive IPC in pharmacologic thromboprophylaxis and pharmacologic thromboprophylaxis for venous thromboembolism. Two researchers extracted data from published reports independently. A meta-analysis was conducted to calculate the risk ratio (RR) using random-effects models. Primary outcomes were deep venous thrombosis (DVT) and pulmonary embolism (PE).
Eight trials with a total of 7,354 participants were eligible for analysis. Addition of IPC to pharmacologic prophylaxis compared to pharmacologic prophylaxis alone reduced the risk of DVT by 43% (RR 0.57, 95% confidence interval [CI] 0.35-0.93; I2 = 0%), with benefit only seen in surgical patients (RR 0.30, 95% CI 0.15-0.59; I2 = 0%) and not in medical patients (RR 0.80, 95% CI 0.60-1.07; I2 = 0%; p for interaction = .008). Addition of IPC reduced the risk for PE by 54% (RR 0.46, 95% CI 0.30-0.72; I2 = 0%), with benefit only seen in surgical patients (RR 0.40, 95% CI 0.24-0.65; I2 = 0%) and not in medical patients (RR 0.82, 95% CI 0.32-2.26; I2 = 0%; p for interaction = .18) CONCLUSIONS: Addition of IPC to pharmacologic prophylaxis confers moderate benefit on venous thromboembolism, with benefit confined to surgical patients. For medical patients, there was a trend toward reduced DVT with adjunctive IPC, which warrants further investigation.
Venous thromboembolism is not unusual among hospitalized patients despite pharmacologic thromboprophylaxis. Nursing personnel should use adjunctive IPC in surgical patients receiving pharmacologic thromboprophylaxis to prevent venous thromboembolism.

OBJECTIVE: To investigate the effect of different use time of intermittent pneumatic compression (IPC) on the incidence of deep vein thrombosis (DVT) of lower extremities after arthroplasty.
METHODS: Between October 2018 and February 2019, 94 patients who planned to undergo unilateral total hip or knee arthroplsty and met the selection criteria were randomly divided into a control group (47 cases) and a trial group (47 cases). There was no significant difference in gender, age, surgical site, and surgical reason between the two groups ( P>0.05). After returning to the ward, all patients were treated with IPC. And the IPC was used until 9:00 pm on the day after operation in the trial group and until 8:00 am the next day after operation in the control group. The levels of hemoglobin, platelet count, D-dimer, hospital stay, treatment costs, patients\' satisfaction with IPC, the parameters of thromboelastrography [kinetics (K value), freezing angle (α angle), reaction time (R value), maximum amplitude (MA value)], visual analogue scale (VAS) score, circumference difference of calf before and after operation, Pittsburgh sleep assessment score, and the incidence of DVT of lower limbs were recorded and compared between the two groups.
RESULTS: The K value and D-dimer before operation were significant different between the two groups ( P<0.05). There was no significant difference in pre- and post-operative hemoglobin, platelet count, and the other parameters of thromboelastography between the two groups ( P>0.05). There was no significant difference in pre- and post-operative VAS scores and post-operative circumference difference of calf between the two groups ( P>0.05). The sleep assessment score of the trial group at 1 day after operation was significant lower than that of the control group ( t=2.107, P=0.038). There was no significant difference in the hospital stay and treatment costs between the two groups ( P>0.05). There was 1 case (2.1%) of DVT, 3 cases (6.4%) of intermuscular venous thrombosis, and 1 case (2.1%) of infection in the trial group, and 2 cases (4.3%), 4 cases (8.5%), and 0 (0) in the control group. The differences were not significant ( P>0.05). After the completion of postoperative IPC treatment, the satisfaction rates of using IPC were 89.4%(42/47) in the trial group and 70.2% (33/47) in the control group, and the difference was not significant ( χ 2=0.097, P=0.104).
CONCLUSIONS: IPC using for a short period of time after arthroplasty do not increase the degrees of the pain and the swelling of calf; it can effectively prevent DVT of the lower extremity, improve the quality of sleep in patients, and is good for the limbs rehabilitation.
UNASSIGNED: 探讨人工关节置换术后间歇充气压力泵（intermittent pneumatic compression，IPC）使用时间对下肢深静脉血栓形成（deep vein thrombosis，DVT）的影响。.
UNASSIGNED: 将 2018 年 10 月—2019 年 2 月拟行单侧人工全髋、膝关节置换术并符合选择标准的 94 例患者纳入研究，按照随机数字表法随机分为对照组（47 例）及试验组（47 例）。两组患者性别、年龄、手术部位及手术原因比较，差异均无统计学意义（ P>0.05）。两组术后返回病房即开始 IPC 治疗，其中试验组使用至手术当天晚上 9 点，对照组至术后第 1 天早上 8 点。记录并比较两组患者以下指标：血红蛋白、血小板计数、D-二聚体水平，住院时间、治疗费用、患者使用 IPC 满意度；血栓弹力图检测，包括凝血形成时间（K 值）、凝固角（α 角）、反应时间（R 值）、血栓最大振幅（MA 值）；疼痛视觉模拟评分（VAS）；手术前后小腿周径差值；匹兹堡睡眠评估量表评估患者睡眠情况；彩色超声多普勒检查下肢 DVT 情况。.
UNASSIGNED: 试验组及对照组患者术前 D-二聚体及血栓弹力图 K 值差异有统计学意义（ P<0.05），术后差异无统计学意义（ P>0.05）；两组手术前后血红蛋白、血小板计数及其他血栓弹力图指标比较，差异均无统计学意义（ P>0.05）。两组患者术前及术后各时间点 VAS 评分比较，术后各时间点小腿周径差值比较，差异均无统计学意义（ P>0.05）。试验组术后第 1 天睡眠评分明显低于对照组（ t=2.107， P=0.038）。两组患者住院时间及治疗费用比较，差异均无统计学意义（ P>0.05）。术后试验组发生下肢 DVT 1 例（2.1%）、肌间静脉血栓 3 例（6.4%）、感染 1 例（2.1%），对照组分别为 2 例（4.3%）、4 例（8.5%）、0 例（0），差异均无统计学意义（ P>0.05）。IPC 治疗结束后，试验组患者使用 IPC 满意率为 89.4%（42/47），高于对照组的 70.2%（33/47），但差异无统计学意义（ χ 2=0.097， P=0.104）。.
UNASSIGNED: 人工关节置换术后短时间应用 IPC，不会增加疼痛及小腿肿胀程度，可有效预防下肢 DVT，改善患者睡眠情况，有利于术侧肢体康复。.

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.