[脑瘤患者手术后血栓栓塞并发症的预防]
A V Bervitsky1,2, V E Guzhin1,2, G I Moisak1,2,3
1Federal Center of Neurosurgery, Ministry of Health of the Russian Federation, Novosibirsk, 630087, Novosibirsk, Russian Federation.
概括
实施静脉血栓栓塞并发症 (VTE) 预防的系统方法,包括风险分层和早期低分子量肝素,显著减少了神经外科患者的肺栓塞.
科学领域:
- 神经外科 神经外科
- 血管外科 血管外科
- 关键护理医学 关键护理医学
背景情况:
- 静脉血栓栓塞并发症 (VTE) 对神经外科患者构成重大风险,特别是在脑瘤切除后.
- 神经外科条件固有地提高了VTE发展的风险.
研究的目的:
- 评估在接受脑瘤切除的患者中系统的静脉瘤预防策略的有效性.
- 该策略涉及风险分层和早期服用低分子量肝素.
主要方法:
- 对3486次脑瘤切除手术的回顾性分析.
- 倾向性得分匹配创建了一个控制组 (n=1002) 和一个研究组 (n=1002),实施新的预防算法.
- 评估了VTE风险分层,早期低分子量肝素使用和并发症率.
主要成果:
- 系统性预防显著减少了临床显著的肺栓塞,从0.6%降至0.2%.
- 在研究小组中,没有肺栓塞相关的死亡事件发生.
- 观察到内出血的轻微增加 (1.3%对1.8%).
结论:
- 手术前的静脉瘤风险分层与早期的低分子量肝素相结合,有效地减少了血栓塞栓事件.
- 这种方法在内出血风险方面提供了可比的安全性.
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