在整形外科和创伤手术中进行血栓预防的渐进式压缩:快速审查和元分析
Dirk Stengel1,2, Daniela Schnorbus1, Axel Ekkernkamp1,2
1BG Kliniken-Klinikverbund der Gesetzlichen Unfallversicherung gGmbH, Leipziger Pl. 1, 10117 Berlin, Germany.
Journal of clinical medicine
|December 11, 2025
概括
在骨科和创伤外科手术中,渐进式压缩 (gCS) 在与现代药物预防一起使用时,对预防血栓栓塞事件没有明显的益处. 它们的一般使用在这些患者群体中不受支持.
科学领域:
- 整形外科手术 整形外科手术
- 创伤外科 手术 创伤外科
- 血管医学 血管医学
背景情况:
- 作为骨科和创伤外科手术中药理性血栓预防的辅助剂,渐进式压缩 (gCS) 的疗效尚不清楚.
- 进行了一项快速审查,以确定gCS是否在预防血栓栓塞 (TE) 事件方面提供了超越现代预防的额外益处.
研究的目的:
- 评估渐进式压缩 (gCS) 在骨科和创伤外科手术中预防血栓栓塞事件的附加值.
- 在第三级创伤中心继续使用gCS的临床决策.
主要方法:
- 对从1980年到2025年发表的随机对照试验 (RCT) 和队列研究进行了快速审查.
- 搜索包括PubMed,MEDLINE,Embase,CINAHL和CENTRAL,重点关注带有和没有gCS的TE预防方案.
- 使用Cochrane RoB-2和ROBINS-I工具评估方法质量,建议使用GRADE.
主要成果:
- 包括15项研究 (13项RCT,2项观察性) 涉及7721名患者.
- 带有gCS和没有gCS的TE事件的汇总相对风险 (RR) 为1.15 (95% CI: 0.80-1.64),有利于没有gCS,具有显著的异质性 (I2: 73%).
- 与gCS或没有gCS进行药理预防的比较研究显示,总结RR为1.44 (95%CI:0.76-2.72).
结论:
- 这项快速审查发现没有明确的好处,以支持在骨科和创伤外科手术中普遍使用渐进式压缩 (gCS).
- 这些发现表明,当有有效的药理预防措施时,通常不建议使用gCS.
- 可能需要进一步的研究来澄清特定的患者子组或场景,其中gCS可能提供边际益处.
关键词:
关节质复原 关节质复原 关节质复原 关节质复原压缩子是一种压缩子.这就是 fondaparinux 的原因.骨折是指骨折,骨折是指骨折,骨折是指骨折,骨折是指骨折.肝激素是一种肝素.骨科 骨科医生 骨科医生骨盆 骨盆 骨盆 骨盆预防 预防 预防 预防脊柱 脊柱 脊柱 脊柱 脊柱血栓塞栓症 血栓塞栓症 血栓塞栓症创伤的创伤创伤的创伤.更多相关视频
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