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大型创伤患者的静脉瘤发作率和风险因素

Bibi Bassa¹, Elizabeth Little², David Ryan³

¹School of Postgraduate studies, Royal College of Surgeons in Ireland, Ireland; Department of Trauma and Emergency Medicine, Mater Misericordiae University Hospital (MMUH), Eccles street, Dublin 7, Ireland.

|October 31, 2024

概括

在重大创伤患者中,静脉血栓塞栓症 (VTE) 发生率在全球范围内差异很大. 深静脉血栓症 (DVT) 的关键风险因素包括手术和骨盆损伤,而肺栓塞 (PE) 风险涉及下肢损伤和年龄较大.

科学领域:

创伤和紧急医疗医学
心血管研究研究心血管研究
临床流行病学临床流行病学

背景情况:

静脉血栓塞栓症 (VTE) 是严重创伤患者的重大并发症.
目前对该群体的VTE风险预测和预防的证据有限,导致不一致的护理.
这次系统性审查的目的是确定VTE率,并在重大创伤队列中确定相关的风险因素.

研究的目的:

在重大创伤患者中系统地审查和综合报告的VTE病率.
在这个患者群体中,识别和分析与静脉瘤相关的危险因素,特别是深静脉血栓塞 (DVT) 和肺栓塞 (PE).

主要方法:

在主要数据库 (MEDLINE,EMBASE,CINAHL,Cochrane,Scopus) 中对1990年至2023年间发表的研究进行了全面的文献搜索.
包括的研究量化了在定义的创伤人群中对静脉瘤发作的发生或评估的风险因素.
数据提取和质量评估由五位独立审查员进行.

主要成果:

22项研究符合纳入标准,主要来自北美 (72%).
报告的VTE发病率差异很大:VTE发病率为0.39%-32%,DVT发病率为0.59%-57.60%,PE发病率为0.35%-24.0%.
持续的DVT风险因素包括手术,延迟预防和骨盆损伤. 对于PE,下肢损伤,男性性别和年龄增加是最常见的. 年龄是DVT和PE的共同因素.

结论:

在重大创伤患者中报告的VTE病率存在显著的全球异质性.
手术程序,延迟预防和骨盆损伤始终与DVT有关,而下肢损伤,男性性别和年龄与PE有关.
研究的异质性阻碍了对DVT和PE之间的风险因素差异的最终结论,需要标准化的报告来进行准确的人口比较.

关键词:

深静脉血栓症 (DVT) 是一种疾病.严重的创伤是严重的创伤.肺内栓塞 (PE) 是一个肺内栓塞.创伤是一个创伤.静脉血栓塞栓症 (VTE) 是一种

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