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在急性创伤性脊髓损伤中静脉血栓塞栓症的管理:了解SCI模型系统中的实践模式
Alyssa Cook1, Brittany Snider1,2,3, Christina Draganich4,5
1Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, USA.
The journal of spinal cord medicine
|November 4, 2025
概括
在创伤性脊髓损伤 (tSCI) 患者中,预防和治疗静脉血栓栓塞 (VTE) 的做法在提供者之间有很大差异. 这凸显了对SCI中VTE管理的标准化,基于证据的临床指导方针的需求.
科学领域:
- 医疗康复 医疗康复
- 神经学 神经学
- 血管医学 血管医学
背景情况:
- 创伤性脊髓损伤 (tSCI) 的幸存者在急性和亚急性康复期间面临静脉血栓栓塞 (VTE) 的风险增加.
- 目前对SCI患者的VTE治疗策略缺乏统一性,影响患者的治疗结果.
研究的目的:
- 调查目前在医疗保健提供者中专门从事VTE预防,监测和治疗的现行做法.
- 为了确定诊断测试,抗凝剂使用和治疗深静脉血栓症 (DVT) 和肺栓塞 (PE) 患者的治疗持续时间的变化.
主要方法:
- 对脊髓损伤模型系统 (SCIMS) 提供商进行了横截面在线调查.
- 该调查利用一个案例场景来评估对患有C6 ASIA损伤量表 (AIS) A四肢的患者的VTE管理决策.
主要成果:
- 订购入院双重扫描存在显著差异,超过一半的医生订购了它们,但只有40%的医生扫描了上肢和下肢.
- 低分子量肝素 (LMWH) 是主要的预防剂,其中素是最常见的. 预防的持续时间各不相同,三分之一的提供者持续了8周或12周.
- 临近DVT的治疗通常涉及LMWH,其次是直接口服抗凝剂 (DOAC) 或单独的DOAC,大多数治疗持续3个月.
结论:
- 在SCI患者中,VTE诊断,预防和治疗的实践在SCIMS中心不同.
- 这种异质性强调了对强有力的研究的迫切需要,以制定最新的,SCI特定的VTE管理临床指南.
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