搜索机械预防措施
抗凝治疗的辅助措施
虽然机械预防方法可有效降低深静脉血栓形成（DVT）的风险，但是与大量的抗凝药物治疗研究相比，对机械预防方法的研究少多了。3
机械预防方法包括梯度压力弹力袜和各种间歇加压设施，都可以增加下肢静脉的回流或减少静脉淤滞的程度。最近的指南推荐机械预防方法主要应用于有出血高风险的患者中，或将其作为抗凝治疗的辅助措施。3
梯度压力弹力袜
梯度压力弹力袜（Graduated compression stockings，GCS) 提供一个环向的压力，从踝关节到大腿的压力逐渐降低。这样增加的压力可促进静脉血液的回流。111
使用GCS进行DVT预防的临床试验结果彼此间有所差异。56, 112, 113 近期一项研究比较了髋关节手术患者(N=874)术后应用磺达肝癸钠+GCS与单独应用磺达肝癸钠在VTE预防方面的差异，结果显示：联合治疗并不比单独使用磺达肝素治疗具有更好的保护效果。114但是，对腹部手术患者的研究结果却显示：联合GCS与药物预防性治疗具有协同作用。115
GCS治疗的禁忌症包括：外周动脉疾病、严重的腿部水肿、周围神经炎、皮肤移植术以及腿部皮炎等。111
间歇充气加压装置
间歇充气加压疗法（Intermittent pneumatic compression ，IPC) 通过一个气泵使绑腿充气膨胀。绑腿反复被充气、放气，以此来增加静脉回流。这种形式与活动时小腿肌肉的自然收缩非常相似，可以促进静脉回流。111
在一项涉及19个临床试验、2255例患者的综合评估中，Roderick 与他同事的评估结果表明：相对于对照组，IPC可降低DVT发生率66％。在疗效方面，置单腔装置与连续加压装置之间没有显著性差异。112
足底静脉泵
足底静脉泵（Venous foot pumps ，VFPs)模仿承重时足底静脉丛的生理性抽吸作用。对于固定不动的患者，这种活动可模仿正常行走的效果以增加腿部的静脉回流。
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Windows Live- 3 - Geerts WH, Pineo GF, Heit JA, et al. Prevention of venous thromboembolism: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest. 2004;126(3 suppl):338S-400S.
- 111 - National Collaborating Centre for Acute Care. Venous Thromboembolism: Reducing the Risk for Surgical Inpatients. London, England: Royal College of Surgeons of England; 2007:1-163.
- 56 - Motte S, Samama CM, Guay J, Barré J, Borg JY, Rosencher N. Prevention of postoperative venous thromboembolism. Risk assessment and methods of prophylaxis. Can J Anaesth. 2006;53(6 suppl):S68-S79.
- 112 - Roderick P, Ferris G, Wilson K, et al. Towards evidence-based guidelines for the prevention of venous thromboembolism: systematic reviews of mechanical methods, oral anticoagulation, dextran and regional anaesthesia as thromboprophylaxis. Health Technol Assess. 2005;9(49). :iii-iv, ix-x, 1-78.
- 113 - Schulz SL, Stechemesser B, Seeberger U, Meyer D, Kesselring C. Graduated compression stockings for the prevention of venous thromboembolism in surgical patients in the age of low molecular weight heparins. J Thromb Haemost. 2005;3(10):2363-2365.
- 114 - Cohen AT, Skinner JA, Warwick D, Brenkel I. The use of graduated compression stockings in association with fondaparinux in surgery of the hip. A multicentre, multinational, randomised, open-label, parallel-group comparative study. J Bone Joint Surg Br. 2007;89(7):887-892.
- 115 - Agnelli G. Prevention of venous thromboembolism in surgical patients. Circulation. 2004;110(24 suppl 1):IV4-IV12.
- 60 - Nicolaides AN, Fareed J, Kakkar AK, et al. Prevention and treatment of venous thromboembolism. International Consensus Statement (guidelines according to scientific evidence). Int Angiol. 2006;25(2):101-161.
- 116 - Wilson NV, Das SK, Kakkar VV, et al. Thrombo-embolic prophylaxis in total knee replacement. Evaluation of the A-V Impulse System. J Bone Joint Surg Br. 1992;74(1):50-52.
- 117 - Warwick D, Harrison J, Whitehouse S, Mitchelmore A, Thornton M. A randomised comparison of a foot pump and low-molecular-weight heparin in the prevention of deep-vein thrombosis after total knee replacement. J Bone Joint Surg Br. 2002;84(3):344-350.
