当下时机：钝性脾损伤的静脉血栓栓塞预防
Time is now: venous thromboembolism prophylaxis in blunt splenic injury.
作者信息
Kwok Amy M, Davis James W, Dirks Rachel C, Wolfe Mary M, Kaups Krista L
机构信息
Department of Surgery, UCSF Fresno, 2823 Fresno St., 1(st) Floor Fresno, CA, 93721, USA.
Department of Surgery, UCSF Fresno, 2823 Fresno St., 1(st) Floor Fresno, CA, 93721, USA.
出版信息
Am J Surg. 2016 Dec;212(6):1231-1236. doi: 10.1016/j.amjsurg.2016.09.026. Epub 2016 Sep 30.
BACKGROUND
The safety and timing of venous thromboembolism (VTE) prophylaxis in patients with blunt splenic injuries is not well known. We hypothesized that early initiation of VTE prophylaxis does not increase failure of nonoperative management or transfusion requirements in these patients.
METHODS
A retrospective review of trauma patients with blunt splenic injury was performed. Patients were compared based on initiation and timing of VTE prophylaxis (<24 hours, 24 to 48 hours, 48 to 72 hours, and >72 hours). Patients who received VTE prophylaxis were matched with those who did not. Primary outcomes included were operation or angioembolization.
RESULTS
A total of 497 patients (256 received VTE prophylaxis and 241 did not) were included. There was no difference in the number of interventions based on presence of or time to VTE prophylaxis initiation.
CONCLUSIONS
Early initiation (<48 hours) of VTE prophylaxis is safe in patients with blunt splenic injuries treated nonoperatively, and may be safe as early as 24 hours.
背景
钝性脾损伤患者静脉血栓栓塞症（VTE）预防的安全性和时机尚不清楚。我们假设早期开始VTE预防不会增加这些患者非手术治疗失败或输血需求。
方法
对钝性脾损伤的创伤患者进行回顾性研究。根据VTE预防的开始时间和时机（<24小时、24至48小时、48至72小时和>72小时）对患者进行比较。接受VTE预防的患者与未接受预防的患者进行匹配。主要结局包括手术或血管栓塞。
结果
共纳入497例患者（256例接受VTE预防，241例未接受）。基于VTE预防的存在或开始时间，干预次数没有差异。
结论
对于非手术治疗的钝性脾损伤患者，早期（<48小时）开始VTE预防是安全的，甚至早在24小时可能也是安全的。
Zotero 插件