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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...
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在创伤性腹腔内血瘤中预防性抗凝药.

Florian Wilhelmy1, Michael Gaier2, Gordian Prasse3

  • 1Department of Neurosurgery, University Hospital Leipzig, Liebigstrasse 20, 04103, Leipzig, Germany. florian.wilhelmy@medizin.uni-leipzig.de.

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概括

在严重创伤性脑损伤 (TBI) 后的预防性抗凝血 (AC) 带有腹腔内血瘤 (SDH) 不会增加术后的内出血 (PH). 延迟的AC与PH相关,而不是早期的管理,这表明AC时间对患者的结果至关重要.

关键词:
抗凝剂是一种抗凝剂.神经外科 神经外科在外科手术后的护理术后出血 术后出血血栓塞栓症 血栓塞栓症 血栓塞栓症创伤性脑损伤是一种创伤性脑损伤.

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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:

  • 严重的创伤性脑损伤 (TBI) 与急性腹腔内血瘤 (SDH) 经常发生在神经外科患者中.
  • 越来越多的TBI患者出现了先前存在的疾病,如治疗性抗凝血 (AC) 和并发症.
  • 导致急性-慢性腹腔内出血的低冲击创伤变得越来越普遍.

研究的目的:

  • 调查外科手术期间预防性抗凝剂 (AC) 时间对发病率和死亡率的影响.
  • 分析AC时间与术后内出血 (PH) 和血栓栓塞事件 (TE) 等并发症之间的关联.
  • 为了确定早期预防性AC是否会影响PH或TE的发生.

主要方法:

  • 在2014年1月1日至2019年12月31日期间,对259名患有严重TBI和皮下血瘤 (SDH) 的患者进行了回顾性分析.
  • 对传记和临床数据的评估,重点关注AC的时间和不良事件.
  • 统计分析包括ROC曲线分析,曼-惠特尼U测试,奇平方测试,费舍尔精确测试和后勤回归.

主要成果:

  • 术后内出血 (PH) 发生在13.1%的患者中,其中10.8%需要手术修复.
  • PH与延迟的AC相关 (p=0.010),但与早期的预防性AC无关 (p=0.287).
  • 血栓栓塞栓事件 (TE) 是罕见的 (5.4%),与AC时间没有相关性 (p=0.444). 在24-48小时内预防性AC并没有增加PH.

结论:

  • 延迟的抗凝血 (AC) 与SDH的TBI后的术后内出血 (PH) 有显著的相关性.
  • 早期预防性AC给药 (24-48小时内) 似乎不会增加PH或TE的风险.
  • 这些发现表明,PH不是由预防性AC引起的,AC时间是管理这些患者的关键因素.