在全关节或膝关节置换术后,针对静脉血栓栓塞的长期预防:随机试验的元分析
J W Eikelboom1, D J Quinlan, J D Douketis
1Thrombosis Unit, Department of Haematology, Royal Perth Hospital, Perth, Australia.
Lancet (London, England)
|July 17, 2001
概括
在部或膝关节置换术后的延长预防显著降低了症状性静脉血栓栓塞的风险. 这种延长的治疗对于在接受重大骨科手术的患者中预防血栓至关重要.
科学领域:
- 整形外科手术 整形外科手术
- 预防血栓形成的预防方法
- 药理学 药理学是指药理学的学科.
背景情况:
- 静脉血栓塞栓症 (VTE) 预防的最佳持续时间 整体关节或膝关节置换后的预防仍然不清楚.
- 扩展预防的目的是减少症状性VTE事件.
研究的目的:
- 确定延长时间预防在完全部或膝关节置换后预防症状性静脉血栓栓塞事件的有效性.
主要方法:
- 随机对照试验的系统综述和元分析,比较长期预防 (肝素或华法林) 与安慰剂或没有治疗.
- 数据提取包括症状/无症状VTE,死亡和出血的结果.
- 用于结合结果的Mantle-Haenszel方法.
主要成果:
- 九项试验 (3999名患者) 显示,延长的预防 (30-42天) 显著减少了症状性静脉瘤 (1.3%对3.3%,或0.38).
- 与膝关节置换患者相比,部置换患者观察到更大的风险降低.
- 无症状深静脉血栓的显著减少 (9.6%与19.6%,或0.48) 指出;没有增加大出血,但发生过多的小出血.
结论:
- 长期预防可显著降低全关节或膝关节置换术患者的症状性VTE频率.
- 这意味着每1000名接受治疗的患者中,症状事件减少约20次.
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