基于体重的剂量用于静脉血栓塞栓症在脊柱创伤患者的预防似乎是安全的
Thomas Heye1, Tarendeep Thind1, Allison Jenkins2
1University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas.
The Journal of surgical research
|June 7, 2023
概括
与标准剂量相比,在脊椎损伤患者的静脉血栓栓塞预防中,以体重为基础的埃诺沙巴林没有增加出血并发症. 这一策略是安全的预防手术后血栓.
科学领域:
- 创伤外科手术是什么
- 整形外科手术 整形外科手术
- 药理学 药理学是指药理学的学科.
背景情况:
- 静脉血栓栓塞 (VTE) 是创伤患者死亡和残疾的重要原因.
- 由于对出血风险的担忧,可以推迟启动VTE预防 (VTEP).
- 2019年6月,VTEP指南从固定的剂量转变为基于体重的埃诺沙巴林.
研究的目的:
- 为了比较基于体重和标准的埃诺沙巴林剂量协议之间的术后出血并发症.
- 评估基于体重的VTEP在经过手术稳定的脊椎创伤患者的安全性.
主要方法:
- 使用机构创伤数据库进行回顾性前后队列研究.
- 包括因脊柱损伤而经过手术稳定治疗的患者.
- 在固定剂量 (每天两次30毫克或每天40毫克) 和基于体重 (0.5毫克/千克每12小时) 的埃诺沙巴林方案之间比较出血并发症,手术后24-48小时开始.
主要成果:
- 该研究包括68名患者在干预前 (固定的剂量) 组和68名患者在干预后 (基于体重) 组.
- 固定剂量组的出血并发症率为2.94%,基于体重的组为0%.
- 这两个群体之间的人口统计数据是可比的.
结论:
- 在脊椎骨折手术后24-48小时开始的VTEP的基于体重的埃诺沙巴林,与标准剂量相比,在出血并发症方面表现出类似的安全性.
- 该研究的局限性包括样本规模小,出血事件发生率低.
- 建议进行更大规模的多中心试验来验证这些发现.
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