Abstract:Objective To evaluate the safety and validity of layered measures in protecting spine surgery patients from deep venous thrombosis.Methods A total of 714 patients were recruited who had managed in the second affiliated hospital of Inner Mongolia medical university for spine surgery from 2015.03 to 2016.03.All cases were assessed the thrombosis risk factors according to Caprini criteria and guarded layered against thrombosis on the basis of VTE.Preventive measures comprised the physical prevention,including grading pressure stretch hose (thigh-length thromboembolic deterrent stockings,TEDS) and intermittent pneumatic compression devices (pneumatic sequential compression will device,PSCD),and drug prevention with use of low molecular heparin intramuscular injection.Lower extremities vascular doppler ultrasound was performed prior to operation and on the day patients were enough to walk after surgery (people unable to walk was performed after 7~14 day of surgery) in order to evaluate for deep vein thrombosis.Postoperative flow and drainage of liquid color were monitored as well,whether having the incision hematoma,errhysis,whether epidural bleeding induced nerve injury symptoms and low molecular heparin induced thrombocytopenia occur were observed and recorded simultaneously.Results 714 cases of spinal surgery patients (8 cases of combined spinal cord or cauda equina nerve damage.) were inspected using the double lower extremities vascular doppler ultrasound and DVT occurred in 16 cases,incidence of DVT was 2.24%.According to the Caprini score,there was one case suffering from DVT in 119 patients of high-risk group (0.08%),and 15 DVT cases in 594 patients of very high risk group (2.53%).No patients had pulmonary embolism (PE).The thrombus were all Peripheral ones,rather than hybrid and central thrombus,that included one popliteal venous thrombosis case(0.14%),3 posterior tibial vein thrombosis case (0.42%),and 2 venous thrombosis cases (0.28%),10 muscular venous thrombosis cases (1.40%).DVT occurred on the left leg in 10 cases,right leg in 5 cases and double lower limbs in 1 case,in 9 cases of male and 7 cases of female by gender.12 cases had typical clinical symptoms and signs and 4 cases were symptomless.Results of postoperative 3 months doppler ultrasound showed the recanalization in all DVT cases.The incision errhysis occurred in 4 cases,incision hematoma in 1 case,epidural hematoma,low molecular heparin induced thrombocytopenia did not appear.Conclusion Caprini scale was taken to spinal postoperative VTE risk classification and individualized prevention according to the grading.All patients with spine surgery take physical prevention combined with anticoagulation drugs to guard against VTE.The results revealed that incidence of DVT was comparatively lower and main type was less dangerous plexus venosus leg muscle thrombosis.In the research,incision errhysis occurred in 4 cases,incision hematoma in 1 case.Besides,no epidural bleeding induced nerve injury symptoms and low molecular heparin induced thrombocytopenia happened.Therefore,we can preliminarily consider the preventive solution of this research to be a safe and effective therapy in postoperative thromboembolism prophylaxis for spinal surgery patients.
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