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日本重症监护病房目前对静脉血栓栓塞症的预防措施

Current prevention practice for venous thromboembolism in Japanese intensive care units.

作者信息

Yamamoto Takeshi, Nakamura Mashio, Kuroiwa Masayuki, Tanaka Keiji

机构信息

Division of Intensive and Cardiovascular Care Unit, Nippon Medical School Hospital, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan,

出版信息

J Anesth. 2013 Dec;27(6):931-4. doi: 10.1007/s00540-013-1626-4. Epub 2013 May 7.

Abstract

Venous thromboembolism (VTE) is a well-recognized life-threatening complication in the intensive care unit (ICU). However, no data have been reported regarding the prevalence and methods of prevention of VTE in Japanese ICUs. This study aimed to document the current practice of VTE prevention across a broad sample of medical-surgical ICU patients in Japan. In November 2010, we performed a point-prevalence survey of Japanese ICUs in training facilities for intensive care specialists. We recorded data from five consecutive ICU patients in each facility at any time on the day of the survey. A total of 470 patients were registered in this study. VTE prophylaxis was received by 85.3 % of participants. Of these, 69.8 % received mechanical prophylaxis and 12.5 % received pharmacological methods, with 17.7 % receiving both methods. Analyzing a comparison of the presence or absence of a hospital prevention protocol, the protocol group had higher rates of receiving prophylaxis (88.8 % vs. 80.0 %, P < 0.01) than the no-protocol group. In conclusion, VTE prophylaxis by mechanical methods was the main method in a high number of medical-surgical ICU patients in Japan. The ICUs with a hospital VTE prevention protocol in place performed significantly higher rates of prophylaxis than those without a protocol.

摘要

静脉血栓栓塞症(VTE)是重症监护病房(ICU)中一种公认的危及生命的并发症。然而,关于日本ICU中VTE的患病率及预防方法尚无数据报道。本研究旨在记录日本内科及外科ICU患者广泛样本中VTE预防的当前实践情况。2010年11月,我们对重症监护专科培训设施中的日本ICU进行了一次现况调查。在调查当天的任何时间,我们记录了每个设施中连续5例ICU患者的数据。本研究共登记了470例患者。85.3%的参与者接受了VTE预防措施。其中,69.8%接受了机械预防措施,12.5%接受了药物预防方法,17.7%同时接受了两种方法。分析有无医院预防方案的比较情况,有方案组接受预防措施的比例(88.8%对80.0%,P<0.01)高于无方案组。总之,在日本,大量内科及外科ICU患者中,机械方法预防VTE是主要方法。实施了医院VTE预防方案的ICU预防措施实施率显著高于未实施方案的ICU。

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