在外科手术管理中心推广静脉血栓栓塞预防方案
Himuro Fujiwara1, Chizuru Yamashita1, Takahiro Kawaji1
1Department of Anesthesiology and Critical Care Medicine, Fujita Health University, School of Medicine, Toyoake, Aichi, Japan.
Fujita medical journal
|August 9, 2023
概括
实施手术前静脉血栓栓塞 (VTE) 协议显著增加了手术前静脉血栓塞检测率. 这种增强的诊断有助于二次血栓预防,并可能预防术后肺栓塞 (PE).
科学领域:
- 麻醉学 麻醉学
- 血管外科 血管外科
- 内部医学 内部医学
背景情况:
- 外科手术期间的静脉血栓塞栓症 (VTE) 是一个关键的并发症.
- 术前诊断和血栓预防对于患者的安全至关重要.
- 建立了一个外科手术管理中心 (PMC) 以改善患者护理.
研究的目的:
- 评估手术前VTE协议对VTE检测率的影响.
- 评估该方案对随后的VTE治疗的影响.
- 为了确定新的术后肺栓塞 (PE) 的发生率.
主要方法:
- 追溯性研究比较患者在 (PMC前) 和 (PMC后) PMC实施前.
- 对20岁以上的选择性麻醉患者的分析.
- 术前下肢压缩超声波 (CUS),VTE检测,抗凝治疗和术后PE率的比较.
主要成果:
- 与PMC前组相比,PMC后组的术前CUS (25.6%对7.2%) 和VTE检测率 (3.93%对1.43%) 与PMC前组相比显著更高 (P<0.001).
- 手术前静脉动脉瘤的抗凝治疗率相似 (88.9%与84.7%,P=0.43).
- 在这两组中都没有出现新的术后PE;治疗的疗效和安全性是可比的.
结论:
- 由PMC推广手术前VTE协议有效增加了手术前CUS和VTE检测.
- 这种改进的检测可以促进二次血栓预防.
- 该协议可能有助于预防手术后PE.
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