现在是时候摆脱DICH (延迟内出血) 了吗?
Emmanuel Luciano1,2, Bianca Marquez1, Akram Alashari1
1Surgery, Central Michigan University College of Medicine, Saginaw, USA.
Cureus
|February 27, 2025
概括
延迟内出血 (DICH) 很少发生在接受血液稀释剂的头部创伤患者中. 如果没有神经变化,重复头部CT通常是不必要的,这可能会减少住院时间和费用.
科学领域:
- 神经学 神经学
- 放射学 放射学是一门学科.
- 紧急医疗 紧急医疗
背景情况:
- 延迟内出血 (DICH) 是使用抗血小板或抗凝药的患者头部创伤后罕见但已知的并发症.
- 这一患者群的发生率和重复成像的必要性仍然是临床不确定性的领域.
研究的目的:
- 为了调查DICH不太可能发生在接受抗凝剂/抗血小板药物的患者中,而没有头部撞击史和头部/面部创伤的可见迹象的假设.
- 评估在接受抗凝血剂/抗血小板治疗期间头部创伤的患者中DICH的发生率.
主要方法:
- 一项为期两年的回顾性研究 (2020-2021) 分析了接受抗血小板/抗凝药治疗的头部创伤患者.
- 收集的数据包括最初的头部CT发现,需要观察,并重复头部CT结果.
- 这项研究评估了DICH与创伤的临床症状之间的关联.
主要成果:
- 在259名患者中,在抗凝血剂/抗血小板药物对头部产生影响时,225名 (86.9%) 的头部CT初始呈阴性.
- 对217名患者 (96.4%) 进行了重复头部CT,只发现了一例 (0.46%) DICH.
- 单个患有DICH的患者不需要神经外科干预.
结论:
- 在头部创伤后服用抗凝血剂/抗血小板药物的患者中,DICH不太可能发生,特别是如果没有神经变化.
- 常规重复头部CT扫描可能是不必要的,可能会减少住院时间和医疗费用.
- 需要加强培训来管理这些药物的头部创伤患者.
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