Efficacy And Safety Of Low Molecular Weight Heparin Treatment, Intermittent Pneumatic Compression Therapy Passive Ankle Exercise And Nursing Care In Preventing Deep Venous Thrombosis Of The Lower Extremity Following Varicose Vein Surgery

Objective: This study was designed to investigate the differences of three modalities, low molecular weight heparin (LMWH) prophylaxis, intermittent pneumatic compression (IPC) therapy and passive ankle exercise, and nursing care in preventing deep venous thrombosis (DVT) in the lower extremity. Methods: A total of 352 patients undergoing varicose vein surgery and secondary care from January 2011 to December 2013 were selected for this study. The patients were randomly divided into control (n = 92), LMWH (n = 85), IPC (n = 87) and passive ankle exercise (n = 88) groups. The effect of the three different treatments and nursing care on prevention of DVT in the lower extremity was studied according to the clinical criteria (symptoms and signs), blood flow velocities, internal vessel diameters and coagulation index by Color Doppler ultrasonography, and activated partial thromboplastin time. A follow-up was performed for all patients and varicose recurrence rate and incidence of saphenous nerve injury were recorded. Results: Compared with the control group, the patients in the LMWH, IPC and passive ankle exercise groups showed reduced DVT incidence, and the passive ankle exercise group showed the least DVT incidence. There were significant differences in terms of blood flow velocities, internal vessel diameters, coagulation index, circumferences of the thigh and calf, and swelling indexes before and after operation in the LMWH, IPC and passive ankle exercise groups; but there was no significant difference among the three groups. The total efficacies (significant effective + effective + improved) of these three methods were 97.58%, 97.70% and 98.86%, respectively, and there was no significant difference. Conclusion: LMWH, IPC and passive ankle exercise all showed a certain effect on the prevention of DVT in the lower extremity. And the efficacy of passive ankle exercise was the strongest.