[Preventive and therapeutic effects of pneumatic compression therapy on deep vein thrombosis after hip and knee replacement surgery in elderly patients with osteoarthritis].

OBJECTIVE: To investigate the application of pneumatic compression therapy in elderly patients with osteoarthritis (OA) undergoing hip and knee replacement surgery,and to evaluate its efficacy and safety in the prevention and treatment of deep vein thrombosis (DVT).

METHODS: From April 2022 to April 2024,100 elderly OA patients who underwent hip or knee replacement surgery were enrolled. They were divided into a control group and a study group according to different treatment methods. Among them,50 patients in the control group received conventional comprehensive therapy,including 26 males and 24 females,aged 60 to 80 years with a mean of (69.62±7.13) years;OA duration was 9 to 19 years with a mean of (14.78±3.64) years;affected side:left 17 cases,right 17 cases,bilateral 16 cases. Other 50 patients in the study group received pneumatic compression therapy in addition to conventional prevention and treatment,including 25 males and 25 females,aged 61 to 80 years with a mean of (68.92±6.48) years;OA duration was 9 to 20 years with a mean (14.54±4.72) years;affected side:left 18 cases,right 17 cases,bilateral 15 cases. Both groups were treated continuously for 7 days. The incidence of postoperative DVT and lower limb swelling were recorded. The femoral vein blood flow velocity and coagulation parameters were measured before and after treatment. Adverse reactions during treatment were observed.

RESULTS: All patients achieved primary wound healing. All 100 patients were followed up for 12 to 24 months with a mean of(16.85±3.11) months. The incidence of DVT in the study group at 7 days after surgery was significantly lower than that in the control group(P<0.05). There was a significant difference in lower limb swelling grade between the two groups(P<0.05). After treatment,the blood flow velocities of the femoral and popliteal veins in both groups were significantly higher than before treatment(P<0.05),and the study group showed higher velocities than the control group(P<0.05). Compared with before treatment,prothombin time (PT) and activited partial thomboplastin time (APTT) were significantly prolonged (P<0.05),while fibrinogen (FIB) and D-dimer were significantly decreased(P<0.05) in both groups after treatment. The study group showed longer PT and APTT and lower FIB and D-dimer levels than the control group(P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).

CONCLUSION: Pneumatic compression therapy is effective in preventing and treating DVT after hip and knee replacement surgery in elderly OA patients,as it accelerates blood flow velocity and improves coagulation function. It is safe and reliable,but contraindications such as bleeding tendency and skin damage should be considered in clinical application to avoid potential risks.