隔离远端深静脉血栓症重症患者的抗凝药:一个回顾性队列研究
Shengxin Fan1, Binyan Fu1, Jiazhou Liu1
1Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400016, China.
BMC cardiovascular disorders
|September 1, 2025
概括
在危急病患者中,早期治疗隔离远端深静脉血栓 (IDDVT) 显著减少了血栓的扩散. 这种方法没有增加出血风险,为重症监护机构的DVT管理提供了潜在的好处.
科学领域:
- 危急护理医学
- 血管医学
- 血栓形成研究
背景情况:
- 在危急病患者中,隔离远端深静脉血栓 (IDDVT) 的抗凝固药物是有争议的.
- 在这种患者群体中评估抗凝剂的益处至关重要.
研究的目的:
- 在被诊断为IDDVT的危急病患者中评估抗凝剂的疗效和安全性.
- 确定抗凝剂是否会减少血栓的扩散和相关的不良事件.
主要方法:
- 通过超声波诊断的IDDVT重症患者的回顾性队列研究.
- 患者分为抗凝和非抗凝组.
- 使用倾向分数匹配 (PSM) 来比较结果,包括血栓传播,出血和死亡率.
主要成果:
- 与不使用抗凝剂相比,抗凝剂显著降低了血栓的传播 (5, 7% 与18, 9% 相比).
- 在PE,PDVT或死亡率等二次结果中没有观察到显著的差异.
- 手术是传播的风险因素,而早期的抗凝血是保护性的;活跃的恶性瘤,创伤和高的IMPROVE得分增加了出血风险.
结论:
- 早期的低剂量抗凝药可以有效地减少IDDVT重症患者的血栓扩散.
- 这种策略似乎不会增加出血风险.
- 由于出血风险升高,建议在患有恶性瘤,创伤或IMPROVE得分高的患者中谨慎使用.
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