Auguste Kurtis I, Quiñones-Hinojosa Alfredo, Berger Mitchel S
Department of Neurological Surgery, Brain Tumor Research Center, University of California, San Francisco School of Medicine, San Francisco, California 94143-0112, USA.
Neurosurg Focus. 2004 Oct 15;17(4):E3. doi: 10.3171/foc.2004.17.4.3.
Patients with brain tumors are at considerable risk for the formation of venous thromboemboli. One method of preventing these complications is mechanical prophylaxis in which an external pneumatic compression device and graduated elastic compression stockings are used. Evidence indicates that these devices prevent deep venous thrombosis (DVT) and pulmonary embolism (PE) by limiting venous stasis and increasing fibrinolytic activity at both the local and systemic levels. The authors present evidence for the occurrence of both mechanisms and discuss the use of mechanical compression in the setting of surgery for brain tumors. They also present data proving the efficacy of these devices in patients who undergo craniotomy with motor mapping for resection of glioma and in whom the contralateral leg receives no prophylaxis. Finally, they comment on the use of anticoagulation therapy both in addition to and in place of mechanical prophylaxis.
脑肿瘤患者发生静脉血栓栓塞的风险相当高。预防这些并发症的一种方法是机械预防，即使用外部气动压缩装置和分级弹性压缩长袜。有证据表明，这些装置通过限制静脉淤滞和提高局部及全身水平的纤维蛋白溶解活性来预防深静脉血栓形成（DVT）和肺栓塞（PE）。作者提供了这两种机制发生的证据，并讨论了在脑肿瘤手术中使用机械压迫的情况。他们还展示了数据，证明这些装置在接受运动功能定位的开颅手术以切除胶质瘤且对侧腿部未进行预防的患者中是有效的。最后，他们对除机械预防之外以及替代机械预防使用抗凝治疗的情况进行了评论。
