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基于证据的间歇性气动压迫装置预防创伤患者静脉血栓栓塞的综述

An Evidenced-Based Review of the Prevention of Venous Thromboembolism in Traumatic Patients with Intermittent Pneumatic Compression Devices.

作者信息

Zeng Meng, Wu Zhoupeng

机构信息

Department of Orthopedics, West China Hospital, Sichuan University, 37 GuoXue Alley, Chengdu 610041, Sichuan, China.

Department of Vascular Surgery, West China Hospital, Sichuan University, 37 GuoXue Alley, Chengdu 610041, Sichuan, China.

出版信息

Emerg Med Int. 2023 Aug 7;2023:2116496. doi: 10.1155/2023/2116496. eCollection 2023.

Abstract

OBJECTIVE

To search, evaluate, and summarize the best evidence of intermittent pneumatic compression devices to prevent venous thromboembolism in trauma patients.

METHOD

Evidence retrieval was conducted from top to bottom according to the "6" evidence model, including guidelines, clinical decision making, evidence summary, expert consensus, and systematic reviews. The retrieval time limit was from the establishment of the database to August 31, 2022. Two researchers independently evaluated the quality of the literature, extracted evidence, and summarized evidence.

RESULTS

A total of 140 studies were obtained in the literature retrieval, and 50 studies were obtained after rechecking and reading the title and abstract. After combining the inclusion and exclusion criteria, 19 studies were finally included. Among them, there were 12 guidelines, 1 clinical decision making, 1 evidence summary, 1 expert consensus, and 4 systematic reviews. The 27 best pieces of evidence were summarized from the four dimensions of pretreatment evaluation, contraindications and applicable conditions, treatment strategies, training, and patient education.

CONCLUSION

This study summarized the evidence of using an intermittent pneumatic compression device to prevent venous thromboembolism in trauma patients and provided the basis for scientific and effective standardized management of mechanical thromboembolism prevention. When applying evidence, it is necessary to combine clinical practice and patient wishes and select evidence pertinent to improving the effectiveness of intermittent pneumatic compression devices in preventing venous thromboembolism. In addition, compliance with the clinical application of IPC is relatively low, so we should start from two aspects before the application of evidence. We should not only increase the number of IPCs but also strengthen the training of VTE prevention knowledge and practical skills of medical staff to provide good health education for patients and their families to improve compliance with the clinical application of IPC.

摘要

目的

检索、评估并总结间歇式气动压迫装置预防创伤患者静脉血栓栓塞的最佳证据。

方法

按照“6”证据模型自上而下进行证据检索,包括指南、临床决策、证据总结、专家共识及系统评价。检索时限为从数据库建库至2022年8月31日。两名研究者独立评价文献质量、提取证据并总结证据。

结果

文献检索共获得140篇研究,经再次核对标题和摘要后获得50篇研究。结合纳入和排除标准,最终纳入19篇研究。其中有12篇指南、1篇临床决策、1篇证据总结、1篇专家共识和4篇系统评价。从预处理评估、禁忌证与适用条件、治疗策略、培训及患者教育四个维度总结出27条最佳证据。

结论

本研究总结了使用间歇式气动压迫装置预防创伤患者静脉血栓栓塞的证据,为机械性血栓预防的科学有效规范管理提供了依据。在应用证据时,需结合临床实际和患者意愿,选择与提高间歇式气动压迫装置预防静脉血栓栓塞效果相关的证据。此外,IPC临床应用的依从性较低,因此在应用证据前应从两方面着手。既要增加IPC的使用数量,又要加强医务人员VTE预防知识及实践技能培训,为患者及其家属提供良好的健康教育,以提高IPC临床应用的依从性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/88b6/10425255/b2c9bba9e8ba/EMI2023-2116496.001.jpg

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