A randomized controlled trial of different physical methods for preventing deep venous thrombosis of lower extremities after pelvic fracture operation

Objective To explore the clinical efficacy of anticoagulant combined with intermittent pneumatic compression (IPC) device and graduated compression stockings (GCS) on preventing deep venous thrombosis (DVT) of lower extremities. Methods From January 2013 to June 2017, 210 patients were enrolled in the prospective randomized controlled study, and assigned into IPC group, GCS group and the combination group (IPC+GCS) with 70 patients in each group. The patients of the three groups were administrated with anticoagulant. And the patients in IPC group were managed with intermittent pneumatic compression, the patients in the GCS group with graduated compression stockings, and the combination group with IPC+GCS. On the first day before the operation, the second and seventh day after the operation, the levels of plasma D-dimer were tested, and color Doppler ultrasonography was performed for DVT. CT pulmonary angiography was conducted on patients suspected of pulmonary embolism for confirming the diagnosis. Results On 7th days after the operation, the difference between in the incidence of total DVT, intramuscular DVT and plasma D-dimer levels among the three groups were statistically significant (all P<0.05). There was no significant difference in the incidence of proximal DVT and distal DVT among the three groups (all P>0.05). Conclusion On the basis of using anticoagulation, when compared with IPC or GCS alone, the combining use of IPC and GCS can significantly reduce the plasma concentration of D-dimer and the incidence of calf intermuscular DVT after pelvic fracture.