在患有急性创伤性脑损伤的成年人中进行静脉血栓塞栓预防:系统性审查
Mary L Forte1, Sallee Brandt1, Amy Marie Claussen1
1University of Minnesota System, Minneapolis, Minnesota, USA.
Trauma surgery & acute care open
|June 24, 2025
概括
对创伤性脑损伤 (TBI) 的静脉血栓塞栓症化学预防 (VTEp) 的最佳时间和类型尚不清楚. 目前的证据对于临床决策是不够的,强调了需要更好的研究设计和标准化的报告.
科学领域:
- 神经科学是一个神经科学.
- 医学研究 医学研究
- 临床试验 临床试验
背景情况:
- 对于急性创伤性脑损伤 (TBI) 的最佳静脉血栓栓塞化学预防 (VTEp) 时间和类型尚未确定.
- 现有证据综合强调了在了解VTEp在TBI管理中的作用方面存在的关键差距.
研究的目的:
- 系统地审查和综合有关急性TBI成年人VTEp的时间和类型的证据.
- 确定证据缺口,并为TBI VTEp.中未来的研究方向提供信息.
主要方法:
- 到2024年11月,对随机和非随机研究进行系统审查.
- 包括报告VTEp时间或急性TBI成年人中的药物研究.
- 定性综合侧重于使用先进分析方法 (AAMs) 和评估偏差风险 (ROB) 的研究.
主要成果:
- 包括21项非随机化研究,其中大多数在临界ROB.
- 关于VTEp时间的证据显示,神经外科干预和肺栓塞的结果各不相同,早期VTEp与较少的深静脉血栓相关.
- 对于大多数结果,低分子量肝素和未分离肝素之间没有发现显著差异,但对其他终点的结果是混合的.
结论:
- 关于VTEp时间和急性TBI类型的临床证据质量不足,无法为决策做出决定.
- 未来的研究,标准化的TBI严重程度标签,以及改进的报告对于推进该领域至关重要.
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