Effect Of Venous Foot Pump On Patients’Hemorheology After The Spinal Operation

[Objective]To evaluate the efficacy of venous foot pump (VFP) by testing the variation of hemorheology indexes in peri-operative patients following spinal operation.To prospectively comprehend the dynamical variation of hemorheology indexes of peri-operative patients with spinal cord injury, so as to forecast deep vein thrombosis (DVT) and reduce the germination of DVT through improved the hemorheology.[Methods]Participants with spinal column operation were included based on the inclusion criteria and measured the demographic information. Patients with DVT were excluded diagnosed by the color doppler examination on each lower extremity before operation. The blood sample was taken to test the blood routine, coagulation routine, and hemorheology indexes in the morning when patients were in an empty stomach status before operation. The spinal column surgical nursing care and VFP were given after operation. The mechanism of VFP was to imitate normal human plantar walking and weight-bearing physical vein system, so as to promote the circulation of foot and leg, increase blood flow velocity in venous, and relieve stasis of blood in the veins to prevent DVT. The VFP was used on patients two times per day and60minutes each time, with pulse pressure set as130mmHg (1mmHg=0.133kpa) and aeration cycle repeated every20s. The moderate elastic bandage should be taken into consideration, with1inch between the foot and foot sleeve. If the patients felt uncomfortable or there was a sudden power outage or instrument problems when used VFP, it should be stopped immediately. Preoperative blood sample was taken to compare the hemorheology indexes with those of3days and2weeks post operation. All data were processed using SPSS version11.5. One-way ANOVA was used to compare the hemorheology indexes at different time points and LSD was used if the variance was homogenous or Games-Howell method was used if not for post-Hoc test. Significant levels were set at a P-value of less than0.05.[Results] The changes of hemorheology indexes were shown as the following after using the VFP:(1) The low shear rate, high shear rate of whole blood viscosity, and hematocrit at3days and2weeks after the operation were lower than those preoperative (P<0.05), but there were no significant differences between3days and2weeks postoperation.(2) The K value of the blood sedimentation equation and red cell deformation index of2weeks after the operation were lower than those of3days after the operation (P <0.05), but there was no significant difference between postoperation and preoperation.(3) The red cell assembling index of3days after the operation was lower than that before the operation (P＜0.05), but there was no significant change between preoperation,3days post operationand2weeks post operation.(4) The erythrocyte sedimentation rate were higher of3days and2weeks after the operation than those before the operation (P<0.05), but the erythrocyte sedimentation rate of2weeks after the operation was lower than that of3days after the operation (P<0.05).(5) Plasma viscosity did not change significantly at three time points.[Conclusions](1) Three days after using the VFP, the whole blood viscosity, hematocrit, and erythrocyte aggregation indexes slightly decreased than those before the operation, but the K value of the blood sedimentation equation, erythrocyte deformation indexes and plasma viscosity had no obvious change. The blood viscosity and hematocrit slightly decreased in2weeks after the operation than those before the operation, and the K value of the blood sedimentation equation, erythrocyte deformation indexes slightly decreased than those3days after the operation. Therefore, using the VFP can effectively improve the changing of blood rheology in peri-operative patients with spinal operation.(2) By changing the blood rheology, the VFP reduces the blood viscosity, improves the blood circulation and prevents the deep venous thrombosis of lower extremity.(3) The implementation of VFP improves blood rheology changes in clinical work. Observation of the variation of hemorheology in peri-operative patients with spinal operation can help caregivers understand the risk of deep vein thrombosis, and take effective preventive measures to reduce the incidence of DVT.