Уважаемые коллеги! Недавно наткнулся на довольно занимательный абстракт за 2013 год о компрессионной терапии как средстве профилактики ПТС:
Цитата:
Compression stockings to prevent post-thrombotic syndrome: a randomised placebo-controlled trial.
Вкратце: В данном РКИ приняли участие порядка 800 пациентов, наблюдаемых в период с 2004 по 2010 год. Пациенты с первичным проксимальным ТГВ были рандомизированы на 2 группы, одни носили лечебный трикотаж, другие пласебо-трикотаж. Первичным исходом было развитие у пациентов ПТС в сроки от 6 мес и более.
В результате, статистически значимых различий в группах не было выявлено:
Цитата:
From 2004 to 2010, 410 patients were randomly assigned to receive active ECS and 396 placebo ECS. The cumulative incidence of PTS was 14·2% in active ECS versus 12·7% in placebo ECS (hazard ratio adjusted for centre 1·13, 95% CI 0·73-1·76; p=0·58). Results were similar in a prespecified per-protocol analysis of patients who reported frequent use of stockings.
Основное заключение: ношение компрессионного трикотажа не является методом профилактики ПТС у пациентов, перенесших первичный проксимальный тромбоз глубоких вен. Полученные данные не оправдывают рутинное ношение трикотажа после ТГВ:
Цитата:
ECS did not prevent PTS after a first proximal DVT, hence our findings do not support routine wearing of ECS after DVT.
Полный текст абстракта:
Цитата:
Abstract
BACKGROUND:
Post-thrombotic syndrome (PTS) is a common and burdensome complication of deep venous thrombosis (DVT). Previous trials suggesting benefit of elastic compression stockings (ECS) to prevent PTS were small, single-centre studies without placebo control. We aimed to assess the efficacy of ECS, compared with placebo stockings, for the prevention of PTS.
METHODS:
We did a multicentre randomised placebo-controlled trial of active versus placebo ECS used for 2 years to prevent PTS after a first proximal DVT in centres in Canada and the USA. Patients were randomly assigned to study groups with a web-based randomisation system. Patients presenting with a first symptomatic, proximal DVT were potentially eligible to participate. They were excluded if the use of compression stockings was contraindicated, they had an expected lifespan of less than 6 months, geographical inaccessibility precluded return for follow-up visits, they were unable to apply stockings, or they received thrombolytic therapy for the initial treatment of acute DVT. The primary outcome was PTS diagnosed at 6 months or later using Ginsberg's criteria (leg pain and swelling of ≥1 month duration). We used a modified intention to treat Cox regression analysis, supplemented by a prespecified per-protocol analysis of patients who reported frequent use of their allocated treatment. This study is registered with ClinicalTrials.gov, number NCT00143598, and Current Controlled Trials, number ISRCTN71334751.
FINDINGS:
From 2004 to 2010, 410 patients were randomly assigned to receive active ECS and 396 placebo ECS. The cumulative incidence of PTS was 14·2% in active ECS versus 12·7% in placebo ECS (hazard ratio adjusted for centre 1·13, 95% CI 0·73-1·76; p=0·58). Results were similar in a prespecified per-protocol analysis of patients who reported frequent use of stockings.
INTERPRETATION:
ECS did not prevent PTS after a first proximal DVT, hence our findings do not support routine wearing of ECS after DVT.
FUNDING:
Canadian Institutes of Health Research.
Хотелось бы услышать комментарии по этому материалу, поскольку на сегодняшний день, компрессионный трикотаж представляется одним из основных инструментов в профилактике ПТС.
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