Taniguchi Satoshi, Fukuda Ikuo, Daitoku Kazuyuki, Minakawa Masahito, Odagiri Satoru, Suzuki Yasuyuki, Fukui Kozo, Asano Kenichiro, Ohkuma Hiroki
Department of Thoracic and Cardiovascular Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori 036-8562, Japan.
Heart Vessels. 2009 Nov;24(6):425-8. doi: 10.1007/s00380-008-1135-9. Epub 2009 Nov 22.
This study was conducted to clarify the prevalence of venous thromboembolism (VTE) in neurosurgical patients. Prospective study for venous thromboembolism screening after neurosurgery was conducted. Thirty-seven patients were screened by ultrasonography for deep vein thrombosis in the lower extremities at an average of 12 days postoperatively. All patients received standard thromboprophylaxis using graded compression stocking with/without intermittent pneumatic compression following the VTE prevention guidelines. Definitive diagnosis of venous thromboembolism was made by contrast-enhanced whole-body computed tomography. Prevalence of deep vein thrombosis of the lower legs was 13.5% (5/37). Incidence of pulmonary embolism was 60% (3/5) in patients having deep vein thrombosis. All patients having venous thromboembolism were asymptomatic. In high-risk patients, VTE prevalence after neurosurgery was high even under mechanical prophylaxis. Additional pharmacological prophylaxis should be considered for patients with high risk of VTE.
本研究旨在明确神经外科患者静脉血栓栓塞症(VTE)的患病率。开展了神经外科手术后静脉血栓栓塞症筛查的前瞻性研究。37例患者在术后平均12天接受了下肢深静脉血栓的超声检查。所有患者均按照VTE预防指南,使用分级加压弹力袜并辅以/不辅以间歇性气动压迫进行标准的血栓预防。通过对比增强全身计算机断层扫描对静脉血栓栓塞症进行确诊。小腿深静脉血栓的患病率为13.5%(5/37)。发生深静脉血栓的患者中肺栓塞的发生率为60%(3/5)。所有发生静脉血栓栓塞症的患者均无症状。在高危患者中,即使采取了机械预防措施,神经外科手术后VTE的患病率仍很高。对于VTE高危患者,应考虑额外的药物预防措施。