静脉血栓栓塞的变化 在2级创伤中心的骨科创伤患者的预防
Vidushi Tripathi1,2,3,4,5,6, Riley Sevensky1,2,3,4,5,6, Kevin Lu1,2,3,4,5,6
1Vidushi Tripathi, MD, is an Orthopedic Surgery resident physician at Hackensack University Medical Center. She graduated from Weill Cornell Medical College in New York, NY.
概括
患有下肢骨科创伤的患者通常不接受足够的静脉血栓塞栓症 (VTE) 预防. 这项研究发现,纽约创伤中心经常使用非分离氨酸 (UFH),而不是首选的低分子量氨酸 (LMWH).
科学领域:
- 整形外科手术 整形外科手术
- 创伤护理 创伤护理
- 药理学 药理学是指药理学的学科.
背景情况:
- 患有下肢骨科创伤的患者面临着静脉血栓栓塞 (VTE) 的高风险.
- 国家指导方针建议低分子量肝素 (LMWH) 与未分离肝素 (UFH) 相比,用于静脉瘤预防.
- 一个特定的创伤中心的静脉瘤预防实践明显偏离了国家平均值和指导方针.
研究的目的:
- 为了回顾下肢骨科创伤的成年患者的VTE预防实践.
- 在纽约第二级创伤中心确定VTE预防的趋势和异常管理.
- 评估遵守有利于LMWH而不是UFH的机构和国家指导方针.
主要方法:
- 在成年患者下肢骨科创伤的VTE预防的回顾性审查.
- 分析未分离氨酸 (UFH) 和低分子量氨酸 (LMWH) 的剂量.
- 使用皮尔森基平方测试的独立性来确定统计学意义.
主要成果:
- 大约57.3%的患者没有接受手术前的VTE预防.
- 32.8%的人接受了未分离的氨酸 (UFH),只有9.1%的人接受了低分子量氨酸 (LMWH).
- 在所有人口和诊断群体中,UFH比LMWH更频繁地使用,在整体外科单位和整形外科相比,UFH更频繁地使用.
结论:
- 观察到与推的VTE预防实践的显著偏差,LMWH的利用不足和UFH的过度使用.
- 很大一部分患者没有接受任何手术前静脉瘤预防.
- 建议采取多模式干预措施,以改善静脉瘤预防实践,提高患者护理质量.
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