在肝血管栓塞后启动血栓预防的最佳时间
Brianna L Collie1, Nicole B Lyons, Logan Goddard
1Dewitt Daughtry Family Department of Surgery, Ryder Trauma Center, University of Miami Miller School of Medicine, Miami, FL.
Annals of surgery
|June 11, 2024
概括
在创伤患者肝血管栓塞后4872小时开始进行血栓预防 (TPX),以平衡出血风险和静脉血栓塞 (VTE) 预防. 这种时间对于最佳的患者结果至关重要.
科学领域:
- 创伤外科手术是什么
- 血管干预 血管干预
- 血栓预防治疗策略 血栓预防策略
背景情况:
- 肝损伤的创伤患者的血栓预防 (TPX) 非常关键,但由于出血风险而复杂.
- 肝血管栓塞后与TPX定时治疗相关的具体风险尚不清楚.
研究的目的:
- 确定创伤患者肝血管栓塞后启动TPX的最佳时间.
- 为了平衡出血并发症的风险与VTE预防的好处.
主要方法:
- 对1550名接受肝血管栓塞治疗的创伤患者 (2017-2019) 的回顾性分析.
- 排除停留时间小于24小时或同时出现严重伤害的患者.
- 基于TPX开始时间的出血并发症和静脉瘤发病率的分析.
主要成果:
- 在血管栓塞后24至48小时内,观察到TPX开始时出现更高的出血并发症.
- 当TPX在48小时后启动时,观察到VTE率的增加.
- 在之前接受肝脏手术的患者中,早期TPX (<24-72小时) 显著增加了出血,而延迟TPX (>96小时) 增加了DVT风险.
结论:
- 这项研究提供了关于创伤后肝血管栓塞后TPX定时的第一个国家数据.
- 在48至72小时之间启动TPX提供了最佳的安全性,最大限度地减少出血,同时降低VTE风险.
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