脊髓损伤患者深静脉血栓形成的发病率及危险因素：一项Meta分析的系统评价
Incidence and risk factors of deep vein thrombosis in patients with spinal cord injury: a systematic review with meta-analysis.
作者信息
Shang Zhizhong, Wanyan Pingping, Zhang Baolin, Wang Mingchuan, Wang Xin
机构信息
The First Clinical Medical College of Lanzhou University, Lanzhou, China.
Department of Pathology and Pathophysiology, Gansu University of Chinese Medicine, Lanzhou, China.
出版信息
Front Cardiovasc Med. 2023 May 12;10:1153432. doi: 10.3389/fcvm.2023.1153432. eCollection 2023.
BACKGROUND
Spinal cord injury (SCI) is a highly disabling disease with huge public health burden. The complications associated with it, especially deep vein thrombosis (DVT), further aggravate the disability.
OBJECTIVE
To explore the incidence and risk factors of DVT after SCI, in order to provide guidance for disease prevention in the future.
METHODS
A search was performed on PubMed, Web of Science, Embase, and Cochrane database up to November 9, 2022. Literature screening, information extraction and quality evaluation were performed by two researchers. The data was later combined by metaprop and metan commands in STATA 16.0.
RESULTS
A total of 101 articles were included, including 223,221 patients. Meta-analysis showed that the overall incidence of DVT was 9.3% (95% CI: 8.2%-10.6%), and the incidence of DVT in patients with acute and chronic SCI was 10.9% (95% CI: 8.7%-13.2%) and 5.3% (95% CI: 2.2%-9.7%), respectively. The incidence of DVT decreased gradually with the accumulation of publication years and sample size. However, the annual incidence of DVT has increased since 2017. There are 24 kinds of risk factors that may contribute to the formation of DVT, involving multiple aspects of the baseline characteristics of the patient, biochemical indicators, severity of SCI, and comorbidities.
CONCLUSIONS
The incidence of DVT after SCI is high and has been gradually increasing in recent years. Moreover, there are numerous risk factors associated with DVT. Comprehensive preventive measures need to be taken as early as possible in the future.
SYSTEMATIC REVIEW REGISTRATION
www.crd.york.ac.uk/prospero, identifier CRD42022377466.
背景
脊髓损伤（SCI）是一种致残性很高的疾病，给公共卫生带来巨大负担。与之相关的并发症，尤其是深静脉血栓形成（DVT），会进一步加重残疾程度。
目的
探讨脊髓损伤后深静脉血栓形成的发生率及危险因素，为今后的疾病预防提供指导。
方法
截至2022年11月9日，在PubMed、Web of Science、Embase和Cochrane数据库进行检索。由两名研究人员进行文献筛选、信息提取和质量评估。随后使用STATA 16.0中的metaprop和metan命令对数据进行合并。
结果
共纳入101篇文章，涉及223,221例患者。Meta分析显示，深静脉血栓形成的总体发生率为9.3%（95%CI：8.2%-10.6%），急性和慢性脊髓损伤患者深静脉血栓形成的发生率分别为10.9%（95%CI：8.7%-13.2%）和5.3%（95%CI：2.2%-9.7%）。深静脉血栓形成的发生率随着发表年份和样本量的积累而逐渐降低。然而，自2017年以来，深静脉血栓形成的年发生率有所上升。可能导致深静脉血栓形成的危险因素有24种，涉及患者基线特征、生化指标、脊髓损伤严重程度和合并症等多个方面。
结论
脊髓损伤后深静脉血栓形成的发生率较高，且近年来呈逐渐上升趋势。此外，与深静脉血栓形成相关的危险因素众多。未来需要尽早采取综合预防措施。
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