Low-molecular-weight heparin in combination with intermittent pneumatic compression on prophylaxis of venous thromboembolism in patients undergoing hip or knee operation

Objective To investigate the efficacy and safety on prophylaxis of venous thromboembolism(VTE)in patients undergoing hip or knee operation using low-molecular-weight heparin(LMWH) in combination with intermittent pneumatic compression(IPC).Methods 53 cases of hip or knee surgery were treated with LMWH and IPC to prevent VTE.Among them,18 cases were received total hip arthroplastics,7 cases were received total knee arthroplastics,17 cases were received dynamic hip screw(DHS),11 cases of acetabular fracture were received internal fixation with reconstruction plate.Every cases were given LMWH staring with post-operative 8h for 10 days(Once a day) and post-operative IPC for 10 to 14 days.IPC was continuously used for 8h on the day of operation,and used for 2h since second day(1 hour bid).All patients were evaluated by clinical symptom of VTE,colour duplex ultrasonography and measure of platelet count and blood coagulation were performed within 5 to 7 days after operation to check the presence of DVT.Patients suspected with pulmonary embolism underwent computed tomography pulmonary angiography.Colour duplex ultrasonography were performed again for those suspected with DVT after 1 to 3 months of postoperation follow-up.Results Among the 53 cases,4 DVT cases accompanied by lower limb swelling of varying degrees were found,the incidence was 7.54%.The 4 case were occurred within 3 months of the postoperative follow-up period after discharged from hospital.Pulmonary embolism and serious bleeding complications did not occur in all cases.International normalized ration(INR) did not exceed 2.5 and platelet count has not decreased.Conclusion LMWH in combination with IPC can significantly reduce the incidence of VTE after hip or knee surgery,and has a good security.