在药物预防的患者中,部骨折手术后早期深静脉血栓形成
Carlo Rostagno1, Massimo Gatti2, Alessandro Cartei3
1Dipartimento Medicina Sperimentale e Clinica, Università di Firenze, 50134 Firenze, Italy.
Journal of clinical medicine
|February 13, 2025
概括
深静脉血栓症 (DVT) 影响了24%的关节骨折患者手术后. 迟到的手术和多种并发症增加了DVT的风险. 纳德帕林可能比达尔特帕林提供更好的保护.
科学领域:
- 整形外科手术 整形外科手术
- 血管外科 血管外科
- 进行血栓预防治疗.
背景情况:
- 静脉血栓塞栓症 (VTE) 是骨科手术,特别是关节骨折修复后的常见并发症.
- 有效的预防策略至关重要,以减轻这种脆弱患者群体的VTE风险.
研究的目的:
- 为了评估深静脉血栓塞 (DVT) 的发生率,位置和风险因素,在接受关节骨折手术的患者中.
- 评估不同药物预防方案 (达尔特巴林与纳德罗巴林) 在预防DVT方面的有效性.
主要方法:
- 一项前性研究涉及505名在2019年1月至12月期间接受关节骨折手术的患者.
- 术后深静脉血栓 (DVT) 查使用压缩超声波 (CUS) 在术后5-6天之间.
- 患者接受了dalteparin或nadroparin用于药理预防,在入院后12小时内开始.
主要成果:
- 术后DVT的总发病率为24% (121/505名患者),大多数病例涉及远端静脉.
- 独立的DVT预测因素包括手术延迟时间 (p=0.0009) 和两种或两种以上的并发症 (p=0.0198).
- 与达尔特巴林的预防与与纳德罗巴林相比,DVT的风险增加1.7倍.
结论:
- 尽管目前的血栓预防指导方针,深静脉血栓症 (DVT) 仍然是骨骨折手术后的一个重大问题,发生在24%的患者.
- 及时的外科干预和管理患者的并发症对于预防DVT至关重要.
- 纳德罗巴林显示出可能比达尔特巴林更高的疗效,因此需要通过随机对照试验进行进一步的研究.
相关概念视频
Anticoagulant Drugs: Low-Molecular-Weight Heparins
601
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
601
Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
1.1K
Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
1.1K
Disorders of Hemostasis
686
Hemostasis, the process that stops bleeding after a blood vessel injury, is crucial for maintaining the integrity of the circulatory system. However, disorders of hemostasis can disrupt this delicate balance, leading to either excessive clotting or bleeding. These disorders can be broadly classified into thromboembolic disorders and bleeding disorders.
Thromboembolic Disorders
Two factors primarily cause thromboembolic conditions.
Thromboembolic Disorders
Two factors primarily cause thromboembolic conditions.
686
Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors
461
Antiplatelet drugs emerge as frontline defenders against the insidious threat of thromboembolic diseases, where abnormal clots obstruct vital blood vessels. These drugs stand as bulwarks, inhibiting platelet aggregation and clot formation, thereby mitigating the risk of life-threatening conditions like myocardial infarction, coronary artery disease, and thrombotic strokes.
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
461


