Abstract:Objective:To investigate the efficacy of mechanical and pharmacological prophylaxis against deep venous thrombosis(DVT) and pulmonary embolism(PE) following blunt trauma. Low-molecular-weight-heparin（LMWH）,intermittent pneumatic compression（IPC）, and LMWH combined with IPC were used.Methods:Totally 329 patients with blunt fractures and joint injuries from April 2008 to March 2010 were divided into 3 groups randomly. In group 1,98 patients received LMWH injection in 24～48 h after the blunt trauma, once a day.In group 2,107 patients received IPC since hospitalization for 6 h every day.In group 3,102 patients received IPC after hospitalization and retarded LMWH as well. All the patients were evaluated for the clinical symptoms of DVT and PE, examined by colour duplex ultrasonography, and the patients with suspected PE completed the spiral CT pulmonary angiography in 24 h.Results:In group 1,11 cases of DVT(11.22%), 3 cases of PE(3.1%), and 8 cases of big or blocking coagulum(8.2%) were found. In group 2, 27 cases of DVT(25.2%), 14 cases of PE(13.1%), and 11 cases of big or blocking coagulum(10.3%) were found. In group 3,8 cases of DVT(7.8%), 2 cases of PE(2.0%), and 1 case of big or the blocking coagulum(1%) were found. The incidences of DVT and PE in group 1 and 3 were lower than those in group 2 (P <0.05).The incidence of big or blocking coagulum in group 3 was lower than those in group 1 and 2 (P<0.05).Conclusion: After the serious blunt fractures and joint injuries, the early use of IPC and retarded use of LMWH for prophylaxis against deep venous thrombosis following blunt trauma is effective, which also can remarkably reduce the incidence of big or blocking coagulum.
