フットポンプは大腿骨頚部骨折術後の下肢腫脹とFDP D-dimerを低減する

The Foot Pump Reduces Postoperative Leg Swelling and Plasma FDP D-dimer Levels in Femoral Neck Fractures

　抄録：大腿骨頚部骨折の周術期において間欠的空気マッサージ（以下，フットポンプ）が深部静脈血栓症の発生予防に有効かどうか，前向き研究を行い検討した．49例の手術患者をフットポンプ使用群と非使用群の2群に無作為に分けて比較した．両群間で性別，年齢，術前臥床期間，骨折型，術式に有意差はなかった．フットポンプは，下肢の腫脹，特に術後7日目の大腿周囲径とFDP D-dimerの増加を有意に抑制した．D-dimer抑制効果は，特にGamma-nail使用患者において顕著であった．フットポンプは大腿骨頚部骨折の周術期において血栓形成の抑制に有用であると考えられた．

　We performed a prospective randomized controlled trial of the foot pump (FP) system to assess its efficacy in preventing deep vein thrombosis in elderly patients with femoral neck fractures. Forty-nine patients were randomly assigned to a group treated with the FP system or a control group. No significant differences were observed between the FP group and control group in terms of age, sex, duration of illness before surgery, type of fracture, or operative procedure. Patients treated with the FP system had less leg swelling and lower plasma FDP D-dimer levels in both the pre-and postoperative period, especially on the seventh postoperative day (p＜0.05). The beneficial effect of the FP system in loweing D-dimer levels was most marked in the patients treated with a Gamma-nail (p＜0.01). The results of this study showed that the FP system is effective in reducing postoperative leg swelling as well as in preventing thromboembolism secondary to deep vein thrombosis.