在手术性创伤性脑损伤中进行静脉血栓栓塞预防
Jacques Lara-Reyna1, Pemla Jagtiani2, Mert Karabacak3
1Department of Neurological Surgery, University of Illinois College of Medicine at Peoria, Peoria, United States.
Surgical neurology international
|October 7, 2024
概括
在手术后3-5天启动静脉血栓塞栓症 (VTE) 预防似乎对手术后创伤性脑损伤 (TBI) 患者是安全的. 时间因手术的侵入性而异,并发症率较低,支持这些时间框架.
科学领域:
- 神经外科 神经外科
- 创伤外科 手术 创伤外科
- 关键护理医学 关键护理医学
背景情况:
- 静脉血栓栓塞 (VTE) 是创伤性脑损伤 (TBI) 后的一个严重并发症.
- 在手术TBI病例中进行VTE药理预防的最佳时间尚未确立.
- 关于早期启动VTE预防的安全性和有效性存在争议.
研究的目的:
- 确定为TBI进行手术的患者启动VTE药理学预防的时间.
- 根据特定的外科手术程序分析预防时间.
- 报告术后内病态恶化的发生率和VTE事件.
主要方法:
- 对90名手术TBI患者的数据进行了回顾性分析.
- 按手术程序类型 (孔,骨切除,解压骨切除) 划分VTE预防的开始时间.
- 术后内病理和VTE率的评估.
主要成果:
- 87.8%的患者在手术后平均85小时接受了VTE药理学预防.
- 预防时间因手术而异:孔 (66小时),骨切除 (116小时) 和解压式骨切除 (109小时).
- 在5.6%的患者中发生了内病理的恶化;VTE率为3.3%.
结论:
- 在手术后3-5天启动VTE药理预防可能对手术后的TBI患者是安全的.
- 预防的时间应该考虑外科手术的侵入性.
- 由于研究的局限性,需要进一步研究以建立基于证据的指导方针.
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