Low-molecular-weight heparin in combination with intermittent pneumatic compression on prophylaxis of deep venous thrombosis following arthroplasty

Objective Examinating the efficacy and safety on prophylaxis of deep venous thrombosis(DVT) following arthroplasty using low-molecular-weight heparin (LMWH) in combination with intermittent pneumatic compression(IPC) starting with different time. Methods 156 patients undergoing primary arthroplasty from July 2003 to June 2005 were divided into four groups randomly. In the first group, 38 patients used LMWH preoperatively and IPC starting since anesthesia. In the second group, 42 patients did LMWH postoperatively and IPC starting since anesthesia. In the third group, 36 patients did preoperative LMWH and post-operative IPC. In the fourth group, 40 patients did post-operative LMWH and IPC. All patients were examined by colour duplex ultrasonography, valued the clinical symptom of DVT, recorded the volume of blood loss in perioperation and observed complication of hemorrhage. Results In the first group, two cases of DVT (5.26%) were found and the average perioperative volume of blood loss was (1030.8±282.0) ml. In the second group, two cases of DVT (4.76%) were found and the average volume of blood loss was (900.7±246.9) ml. In the third group, one case (2.78%) of DVT was found and the average volume of blood loss was (1040.3±288.5) ml. In the fourth group, nine cases of DVT (22.5%) were found and the average volume of blood loss was (852.2±295.4) ml. Comparing the incidence of DVT between each group, group 1, 2, 3 were lower than group 4(P﹤0.05). Comparing the volume of blood loss in perioperation, group 2 , 4 were less than group 1,3(P﹤0.05). Conclusion On the basis of this study, it is more effective and safer using LMWH staring with post-operative 10 h in combination with IPC starting with anesthesia on prophylaxis of DVT following arthroplasty.