追溯研究支持药物学静脉血栓塞栓症预防在脑内出血后是安全的,未充分使用
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Updated: Sep 16, 2025

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Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation
Published on: October 15, 2021
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Camille Lh Carlisle1, Tamela Stuchiner2, Alexandra Lesko2
1Western University of Health Sciences, College of Osteopathic Medicine of the Pacific Northwest, Lebanon, OR, USA.
The Neurohospitalist
|July 8, 2025
概括
在脑内出血 (ICH) 稳定后启动药物预防是安全的,不会增加出血扩张或静脉血栓栓塞 (VTE) 风险. 这支持目前针对ICH患者VTE预防的指导方针.
科学领域:
- 神经学 神经学
- 血管医学 血管医学
- 关键护理医学 关键护理医学
背景情况:
- 患有自发性非创伤性脑内出血 (ICH) 的患者面临更高的静脉血栓栓塞 (VTE) 风险.
- 目前的指导方针建议药物预防和出血后稳定,通常在24小时内.
- 仍然存在对药物预防的潜在出血扩张的担忧,导致使用不足.
研究的目的:
- 评估在出血稳定后自发非创伤性ICH患者中启动药理学预防的安全性.
- 为了确定药物预防是否会增加出血大小或VTE事件.
主要方法:
- 对228名因非创伤性自发性ICH而出院的成年患者进行了回顾性研究.
- 2018年1月至2021年12月期间从普罗维登斯医疗中心收集的数据.
- 仅接受机械预防的患者与接受药理学预防 (有或没有机械) 的患者之间的结局比较.
主要成果:
- 34.6%的患者接受了药物预防,其中55.7%的患者在稳定后48小时内开始药物预防.
- 两组之间没有观察到VTE事件或出血扩张的显著差异.
- 在患者人口统计学,病史,出血特征或死亡率方面没有显著差异.
结论:
- 在出血稳定后启动药理学预防对于ICH患者来说是安全的.
- 这些发现符合并支持2022年中风指南关于早期VTE预防的建议.
- 在这个人群中,药物预防似乎不会增加出血扩张或VTE风险.
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