对于足踝创伤接受膝下石膏固定治疗的患者，血栓预防措施能否降低有症状的静脉血栓栓塞发生率？一项系统评价和荟萃分析。
Does thromboprophylaxis reduce symptomatic venous thromboembolism in patients with below knee cast treatment for foot and ankle trauma? A systematic review and meta-analysis.
作者信息
Hickey Ben A, Watson Ultan, Cleves Andrew, Alikhan Raza, Pugh Neil, Nokes Len, Perera Anthony
机构信息
University Hospital of Wales, Heath Park, Cardiff CF14 4XW, Wales, UK.
University Hospital of Wales, Heath Park, Cardiff CF14 4XW, Wales, UK.
出版信息
Foot Ankle Surg. 2018 Feb;24(1):19-27. doi: 10.1016/j.fas.2016.06.005. Epub 2016 Jul 18.
BACKGROUND
Our aim was to determine the evidence for thromboprophylaxis for prevention of symptomatic venous thromboembolism (VTE) in adults with foot or ankle trauma treated with below knee cast or splint. Our secondary aim was to report major bleeding events.
METHODS
MEDLINE and EMBASE databases were searched for randomized controlled trials from inception to 1st June 2015.
RESULTS
Seven studies were included. All focused on low molecular weight heparin (LMWH). None found a statistically significant symptomatic DVT reduction individually. At meta-analysis LMWH was protective against symptomatic DVT (OR 0.29, 95% CI 0.09-0.95). Symptomatic pulmonary embolism affected 3/692 (0.43%). None were fatal. 86 patients required LMWH thromboprophylaxis to prevent one symptomatic DVT event. The overall incidence of major bleeding was 1 in 886 (0.11%).
CONCLUSIONS
Low molecular weight heparin reduces the incidence of symptomatic VTE in adult patients with foot or ankle trauma treated with below knee cast or splint.
背景
我们的目的是确定在接受膝下石膏或夹板治疗的足部或踝关节创伤成人中，预防有症状静脉血栓栓塞（VTE）的血栓预防证据。我们的次要目的是报告主要出血事件。
方法
检索MEDLINE和EMBASE数据库，查找从数据库建立至2015年6月1日的随机对照试验。
结果
纳入了7项研究。所有研究均聚焦于低分子量肝素（LMWH）。单独来看，没有一项研究发现LMWH在降低有症状深静脉血栓形成（DVT）方面有统计学显著意义。在荟萃分析中，LMWH可预防有症状DVT（比值比0.29，95%置信区间0.09 - 0.95）。有症状肺栓塞的发生率为3/692（0.43%）。均无致命情况。86名患者需要LMWH进行血栓预防以预防1例有症状DVT事件。主要出血的总体发生率为1/886（0.11%）。
结论
低分子量肝素可降低接受膝下石膏或夹板治疗的足部或踝关节创伤成年患者有症状VTE的发生率。
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