Zorowitz Richard D, Smout Randall J, Gassaway Julie A, Horn Susan D
Physical Medicine and Rehabilitation, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
Top Stroke Rehabil. 2005 Fall;12(4):1-10. doi: 10.1310/9DQM-JTGL-WHAA-XYBW.
Deep venous thrombosis (DVT) is a common and preventable complication after a stroke. Although the treatment of DVT is simple and straightforward, its prevention remains controversial. The Post-Stroke Rehabilitation Outcomes Project (PSROP) database was used to describe the incidence and temporal sequence of DVT and trends in the prevention and treatment of DVT. Of the 1,161 patients in the PSROP database, 383 (32.99%) patients without DVT and 8 (0.69%) with DVT had no documented orders for anticoagulant medications. Sixty-five (5.60%) patients had DVTs during the inpatient rehabilitation facility stay. Of 10 (0.86%) patients with DVTs in the common femoral vein, 4 (40%) were diagnosed within 24 hours of admission. Nine (90%) of these 10 patients were classified as moderate or severe strokes. All patients with common femoral DVT received appropriate therapy. Although much is known about the prevention, diagnosis, and treatment of poststroke DVT, clinicians need to learn and apply treatment protocols to prevent DVTs and allow more quality time for rehabilitation.
深静脉血栓形成(DVT)是卒中后一种常见且可预防的并发症。尽管DVT的治疗简单直接,但其预防仍存在争议。卒中后康复结局项目(PSROP)数据库被用于描述DVT的发生率、时间顺序以及DVT预防和治疗的趋势。在PSROP数据库的1161例患者中,383例(32.99%)无DVT的患者和8例(0.69%)有DVT的患者没有抗凝药物的医嘱记录。65例(5.60%)患者在住院康复机构停留期间发生了DVT。在10例(0.86%)股总静脉发生DVT的患者中,4例(40%)在入院后24小时内被诊断出来。这10例患者中有9例(90%)被归类为中度或重度卒中。所有股总静脉DVT患者均接受了适当治疗。尽管对于卒中后DVT的预防、诊断和治疗已有很多了解,但临床医生需要学习并应用治疗方案来预防DVT,以便为康复留出更多有质量的时间。