Intervention Study Of Applying Intermittent Pneumatic Compression Devices With Different Duration In Prevention Of Deep Vein Thrombosis During Spinal Surgery

Background Surgery is a fast and effective method to treat spinal patients,Which also increase the incurrence.of deep vein thrombosis（DVT）after surgery.Therefore,it is very important to take relevant preventive measures during surgery,At present,it has been reported that intraoperative use of intermittent pneumatic compression devices（IPCD）can effectively reduce the incidence of DVT,but there is no unified standard for the duration of Applying IPCD,and there is no research on the duration of IPCD utilized intraoperatively at home and abroad.Objective This study mainly discusses the effects of different duration of intermittent pneumatic compression devices on deep venous thrombosis and hemodynamics in spinal surgery,To determine the appropriate duration of use,and to provide reference for the prevention of intraoperative DVT.Method In this study,119 patients who met the inclusion and exclusion criteria for elective spinal surgery in a grade III class A hospital in Henan Province from June 2020 to August 2021 were selected as the research objects by convenient sampling method.They were divided into three groups A,B and C according to the random number table method,During the study,patients with incomplete data and withdrawal from the study were excluded,and a total of 118 patients were finally included.All the patients started intermittent pneumatic compression devices immediately at the beginning of the operation.In group A（39 cases）,IPCD was used twice for 30 minutes each time;In group B（39 cases）,IPCD was used twice for 40 minutes each time;In group C（40 cases）,IPCD was used three times,40 minutes each time.During the operation,both lower limbs of patients with IPCD in each group were inflated and deflated at the same time,including inflation time of 40 s and deflation time of 20 s.Same clinical education and rehabilitation guidance to the patients of the three groups were conducted by the same nurse.Except for the different duration of IPCD,all other nursing and parameters of the three groups were the same.By comparing the baseline data,incidence of DVT and intraoperative blood output,flow velocity and diameter of iliac vein,femoral vein and popliteal vein And related coagulation indexes to explore the effects of different duration of IPCD on deep venous thrombosis and hemodynamics in spinal surgery.Result 1.Baseline data: There was no significant difference in BMI,disease type,operation time,complications and age among the three groups（P > 0.05）.2.Incidence of venous thrombosis and intraoperative bleeding: among the 118 patients finally included in this study,4 intramuscular venous thrombosis were found by ultrasound,including 2 cases of intramuscular venous thrombosisdeep in group A（5.1%）and 1 case of intramuscular venous thrombosisdeep in group B and C（2.6% and 2.5%）respectively,and there was no significant difference among the groups（P > 0.05）.There was no significant difference in intraoperative bleeding among the three groups（P > 0.05）.3.Coagulation indexes: the levels of prothrombin time and platelet count in the three groups were not the same at the immediate time node after operation,and the difference was statistically significant（P < 0.05）.Among them,there was statistical significance（P < 0.05）in group A compared with group B and group C,but there was no statistical significance Between group B and group C,and there was no statistical significance in the third day after operation.There was a significant difference in fibrinogen at the time nodes immediately after operation and the third day after operation（P < 0.05）.There was also a significant difference（P < 0.05）in group a compared with group B and group C,but there was no significant difference between group B and group C.There was no significant difference in either coagulation or fibrinolysis indexes at each time point after operation.4.Hemodynamics: there was a significant difference in the peak velocity of common femoral vein at the time nodes immediately after operation and the third day after operation（P < 0.05）.There was significant difference in the diameter of common femoral vein at the time node immediately after operation（P < 0.05）.There was also a significant difference（P < 0.05）between group A and group B and group C,but there was no statistical difference between group B and group C.The peak velocity of iliac vein was statistically significant（P < 0.05）at the time point immediately after operation（P < 0.05）.There was statistical significance in group A compared with group B and group C,there was no statistical significance between group B and group C,and there was no statistical significance in the third day after operation.Conclusion The use of intermittent pneumatic compression devices twice by 40 minutes each time in total in spinal surgery is better than that of twice by 30 minutesand three times by 40 minutes in improving coagulation indexes,promoting the activation of fibrinolytic system and accelerating the peak velocity of venous blood.Without increasing the amount of intraoperative bleeding,it can effectively improve blood hypercoagulability,increase the vascular elasticity and reduce the risk of deep venous thrombosis.