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患有地震相关粉碎综合征的儿科患者的血栓预防:单一中心体验
Feryal Karahan1, Selma Ünal1, Özlem Tezol2
1Faculty of Medicine, Department of Pediatric Hematology, Mersin University, Mersin, Turkey.
Pediatric surgery international
|August 16, 2023
概括
患有地震压伤的儿科患者接受了抗凝剂治疗,以预防静脉血栓塞栓症 (VTE). 这种方法导致该高风险群体的VTE率低至2.1%.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 创伤外科 手术 创伤外科
- 血液学 血液学 血液学
背景情况:
- 粉碎伤害显著增加了静脉血栓栓塞 (VTE) 的风险.
- 有限的数据存在于管理抗凝药治疗的VTE预防在儿童患者的压伤,特别是那些来自大规模伤亡事件的伤害.
- 与地震相关的压缩综合征对儿童的VTE风险评估和管理提出了独特的挑战.
研究的目的:
- 为了分享与地震相关的粉碎综合征的儿科患者治疗抗凝血剂血栓预防的临床经验.
- 评估适应的VTE预防指南在这个特定的儿科创伤人群中的有效性.
- 根据标准化的血栓预防方案,确定儿科压伤患者的静脉动脉突发症率.
主要方法:
- 一组患有地震相关压缩综合征的儿科患者被评估VTE风险.
- 进行了静脉瘤风险分层,通过调整青少年术后静脉瘤预防指南,因为没有针对儿科创伤的静脉瘤指南.
- 基于VTE风险水平 (低,中等,高) 和年龄的基础上,使用埃诺沙巴林的抗凝血药进行了血栓预防.
主要成果:
- 包括49名患有地震相关粉碎综合征的儿科患者.
- 静脉瘤风险分层:14.6%的低风险,27.1%的中等风险,58.3%的高风险.
- 预防性埃诺沙巴林 (enoxaparin) 用于13岁以下的中度风险患者和高风险患者,无法早期动员,以及所有13岁及以上的高风险患者.
结论:
- 在儿科压迫综合征患者中,用于血栓预防的实施决策算法与2.1%的低VTE率有关.
- 适应现有的VTE指导方针用于外科手术期间的青少年患者,在地震相关的压伤伤害中对风险评估和预防有效.
- 这项研究强调了儿童创伤患者主动静脉瘤预防的重要性,即使是在资源有限的灾难环境中.
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