下肢静脉泵预防骨科大手术后深静脉血栓的Meta分析

目的荟萃分析评价下肢静脉泵预防骨科大手术后深静脉血栓的临床效果。方法由2位研究人员独立进行文献检索，数据库包括PubMed、EMBASE、Cochrane图书馆、中国生物医学文献数据库、中国知网、维普和万方数据库，检索主题为下肢静脉泵预防骨科大手术后深静脉血栓的临床效果；对纳入文献提取数据，进行Meta分析。结果共纳入14篇文献进行定量分析。Meta分析结果表明，下肢静脉泵可明显降低深静脉血栓发生率，并可明显改善下肢肿胀。结论下肢静脉泵可明显预防骨科大手术后深静脉血栓，并促进下肢肿胀恢复，值得进一步临床推广应用。

Objective To evaluate the clinical effect of lower limbs venous pump in preventing deep vein thrombosis after major orthopedic surgery. Methods Two researchers independently conducted literature searches. The databases included PubMed, EMBASE, Cochrane Library, China Biomedical Literature Database, China Knowledge Network, Weipu, and Wanfang Database. The retrieving subject was the prevention of deep veins thrombosis following major orthopaedic surgery with a venous pump for the lower hmbs. Data were extracted from included hterature, and a meta-analysis was performed. The search strategy was determined by the first author and corresponding author. The differences arised from the literature search and meta-analysis were decided by the third party. Results A total of 14 articles were included for quantification and the study nature was not randomized or quasi-randomized controlled trials. Subgroup analysis by study type （RCT, non-RCT ） suggested that there was no heterogeneity within and between groups, which could be combined for analysis. The combined RR was： 0.34 （ 95%-CI： 0.25, 0.46 ） . It suggested that the incidence of deep vein thrombosis in the lower limbs venous pump group was significantly lower than that in the control group. Subgroup analysis based on interventions indicated that the intervention rate of venous pumps in the lower limbs alone or in the control group was significantly lower than that in the control group. Subgroup analysis based on the name of the surgery suggested that the incidence of deep venous thrombosis was significantly lower in the lower limbs venous pump group after major orthopaedic surgery. On the 3rd day after operation, the MD of the lower limbs combined was -3.38 （ 95%-CI： -4.39, -2.38 ） , suggested that the lower limbs venous pump group had significantly lower swelling of the lower hmbs than the control group. Conclusions Lower limbs venous pump significantly reduces the incidence of deep venous thrombosis after major orthopedic surgery, and promotes the recovery of lower limbs swelling. However, more high-quality, large-sample randomized controlled trials are needed to further verify the efficacy and promote clinical practice apphcation.