Clinical Observation For The Efficacy Of Mechanical And Pharmacologic Prophylaxis Against Deep Venous Thrombosis Following Blunt Trauma

objective:Examinating the efficacy on prophylaxis of deep venous thrombosis(DVT) and pulmonary embolism(PE) following blunt trauma,using Low-molecular-weight-heparin(LMWH),intermittent pneumatic compression(IPC)and LMWH combination with IPC.Methods : 329 patients undergoing blunt fractures and joint injuries from April 2008 to March 2010 were divided into 3 groups randomly. In the first group,98 patients in 24h～48h used LMWH injection after the blunt trauma,daily one time.In the second group,107 patients used IPC since hospitalization and requested to use above every day 6h.In the third group,102 patients used IPC since hospitalization and retarded to use the LMWH.All patients were valued the clinical symptom of DVT and PE, examined by colour duplex ultrasonography,and the suspicions of PE completed the spiral CT pulmonary angiography in 24h.Results: In the first group,11 cases of DVT(11.22%),3 cases of PE(3.1%) and 8 cases of big or the blocking coagulum(8.2%) were found. In the second group,27 cases of DVT(25.2%),14 cases of PE(13.1%) and 11 cases of big or the blocking coagulum(10.3%) were found. In the third group,8 cases of DVT(7.8%),2 cases of PE(2.0%) and 1 cases of big or the blocking coagulum(1%) were found.Comparing the incidence of DVT and PE between each groups,group 1,3 were lower than group 2 (P <0.05).Comparing the incidence of big or the blocking coagulum between each groups,group3 were lower than the group 1,2 (P <0.05).Conclusion: On the basis of this study,after the serious blunt fractures and joint injuries,the early use IPC and retard to use the LMWH on prophylaxis against deep venous thrombosis following blunt trauma is effective,also can obviously reduce big or the blocking coagulum formation rate.