摘要
目的探讨早期药物抗凝预防创伤性脑损伤(TBI)术后患者静脉血栓栓塞(VTE)的疗效。方法回顾性分析2019年1月—2020年12月宁夏回族自治区人民医院收治的142例中重度TBI术后患者临床资料,所有患者被分为三组。对照组给予单纯物理预防,早期、晚期抗凝组分别在术后≤84 h、>84 h给予物理预防联合低分子肝素100 U/kg,2次/d药物预防,分析各组VTE及颅内血肿进展的发生率,评估早期药物抗凝的疗效。结果早期抗凝组VTE的发生率为3.6%,明显低于对照组的46.4%和晚期抗凝组的24.4%(P<0.0167),晚期抗凝组与对照组VTE发生率无明显差异(P>0.0167);早期抗凝组颅内血肿进展的发生率为14.3%,与对照组、晚期抗凝组的21.4%、14.0%无统计学差异(P>0.05)。结论TBI术后患者给予物理预防联合早期药物抗凝可以有效降低VTE的发生率,且不增加颅内出血的风险。但是对于“早期”的定义,需要更大样本量的随机前瞻性的临床研究。
Objective To investigate the effect of early venous thromboembolism chemoprophylaxis(VTE-CHEMO)for the prevention of venous thromboembolism(VTE)in patients with traumatic brain injury(TBI)after the operation.Methods The clinical data of 142 patients with moderate to severe TBI after operation admitted to People's Hospital of Ningxia Hui Autonomous Region from January 2019 to December 2020 were analyzed retrospectively.All patients were divided into three groups.The control group was given physical prevention alone,and the early and late anticoagulation groups were given physical prevention combined with low molecular weight heparin 100 U/kg twice a day at≤84 h and>84 h after surgery,respectively.The incidence of VTE and intracranial hematoma progression in each group were analyzed,and the efficacy of early drug anticoagulation was evaluated.Results The incidence of VTE in the early anticoagulation group was 3.6%,which was significantly lower than 46.4%in the control group and 24.4%in the late anticoagulation group(P<0.0167).There was no significant difference in the incidence of VTE between the late anticoagulation group and the control group(P>0.0167).The incidence of intracranial hematoma progression in the early anticoagulation group was 14.3%,which had no significant difference from 21.4%and 14.0%in the control group and the late anticoagulation group(P>0.05).Conclusions Physical prevention combined with early drug anticoagulation after TBI can effectively reduce the incidence of VTE,and does not increase the risk of intracranial hemorrhage.However,for the definition of“early stage”,a larger sample size of randomized prospective clinical research is required.
作者
别鹏飞
郭加雨
赵艳斌
杜安东
李敏
马东明
许世辉
BIE Peng-fei;GUO Jia-yu;ZHAO Yan-bin(Department of Neurosurgery,People's Hospital of Ningxia Hui Autonomous Region,Yinchuan 750002,China)
出处
《临床神经外科杂志》
2022年第6期699-702,共4页
Journal of Clinical Neurosurgery
基金
西北民族大学中央高校青年教师创新项目(31920210040)。
关键词
创伤性颅脑损伤
静脉血栓栓塞药物预防
颅内血肿进展
traumatic brain injury
venous thromboembolism chemoprophylaxis
intracranial hemorrhage progression
