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严重多发伤后的静脉血栓栓塞化学预防:预防的时机和类型至关重要。

Venous thromboembolism chemoprophylaxis after severe polytrauma: timing and type of prophylaxis matter.

作者信息

Byrne James P, Schellenberg Morgan

机构信息

Division of Acute Care Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA.

Division of Acute Care Surgery, University of Southern California, Los Angeles General Medical Center, Los Angeles, CA, USA.

出版信息

Eur J Trauma Emerg Surg. 2024 Dec;50(6):2721-2726. doi: 10.1007/s00068-024-02651-3. Epub 2024 Sep 10.

DOI:10.1007/s00068-024-02651-3
PMID:39254696
Abstract

In this review, we provide recommendations as well as summarize available data on the optimal time to initiate venous thromboembolism chemoprophylaxis after severe trauma. A general approach to the severe polytrauma patient is provided as well as in-depth reviews of three high-risk injury subgroups: patients with traumatic brain injury, solid organ injury, and pelvic fractures.

摘要

在本综述中,我们提供了相关建议,并总结了关于严重创伤后启动静脉血栓栓塞化学预防的最佳时机的现有数据。本文给出了针对严重多发伤患者的一般处理方法,并对三个高风险损伤亚组进行了深入综述:创伤性脑损伤患者、实体器官损伤患者和骨盆骨折患者。

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Venous thromboembolism chemoprophylaxis after severe polytrauma: timing and type of prophylaxis matter.严重多发伤后的静脉血栓栓塞化学预防:预防的时机和类型至关重要。
Eur J Trauma Emerg Surg. 2024 Dec;50(6):2721-2726. doi: 10.1007/s00068-024-02651-3. Epub 2024 Sep 10.
2
Chemoprophylaxis and Venous Thromboembolism in Traumatic Brain Injury at Different Trauma Centers.不同创伤中心创伤性脑损伤的化学预防与静脉血栓栓塞
Am Surg. 2020 Apr 1;86(4):362-368.
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Safety of early chemoprophylaxis for venous thromboembolism after traumatic brain injury: a systematic review and meta-analysis. A military traumatic brain injury initiative study.创伤性脑损伤后早期化学预防静脉血栓栓塞的安全性:一项系统评价和荟萃分析。一项军事创伤性脑损伤倡议研究。
J Neurosurg. 2024 Nov 22;142(4):1046-1057. doi: 10.3171/2024.7.JNS232697. Print 2025 Apr 1.
4
A Stitch in Time Saves Clots: Venous Thromboembolism Chemoprophylaxis in Traumatic Brain Injury.及时缝一针,血栓不再有:创伤性脑损伤的静脉血栓栓塞症化学预防。
J Surg Res. 2021 Feb;258:289-298. doi: 10.1016/j.jss.2020.08.076. Epub 2020 Oct 8.
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Association of timing and agent for venous thromboembolism prophylaxis in patients with severe traumatic brain injury on venous thromboembolism events, mortality, neurosurgical intervention, and discharge disposition.严重创伤性脑损伤患者静脉血栓栓塞预防的时机和药物与静脉血栓栓塞事件、死亡率、神经外科干预以及出院转归的关系。
J Trauma Acute Care Surg. 2024 Oct 1;97(4):590-603. doi: 10.1097/TA.0000000000004383. Epub 2024 May 15.
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Venous thromboembolism prophylaxis in neurosurgical trauma patients.神经外科创伤患者的静脉血栓栓塞预防
J Surg Res. 2016 Sep;205(1):221-7. doi: 10.1016/j.jss.2016.06.049. Epub 2016 Jun 24.
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Timing of venous thromboembolism prophylaxis initiation and complications in polytrauma patients with high-risk bleeding orthopedic interventions: A nationwide analysis.高出血风险骨科干预的多发创伤患者静脉血栓栓塞预防起始时间和并发症:一项全国性分析。
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Effects of Early Chemoprophylaxis in Traumatic Brain Injury and Risk of Venous Thromboembolism.早期创伤性脑损伤化学预防与静脉血栓栓塞风险的关系。
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引用本文的文献

1
Intensivist performed compression ultrasound (IPCUS) for screening and early detection of deep venous thrombosis in trauma intensive care unit: a prospective study.在创伤重症监护病房中,重症监护医生使用压迫式超声(IPCUS)筛查和早期检测深静脉血栓形成:一项前瞻性研究。
Eur J Trauma Emerg Surg. 2025 Jul 4;51(1):245. doi: 10.1007/s00068-025-02920-9.

本文引用的文献

1
Preperitoneal pelvic packing in isolated severe pelvic fractures is associated with higher mortality and venous thromboembolism: A matched-cohort study.腹膜外盆腔填塞在孤立性严重骨盆骨折中与更高的死亡率和静脉血栓栓塞相关:一项匹配队列研究。
Am J Surg. 2024 Oct;236:115828. doi: 10.1016/j.amjsurg.2024.115828. Epub 2024 Jul 3.
2
When is it safe to start venous thromboembolism prophylaxis after blunt solid organ injury? A prospective American Association for the Surgery of Trauma multi-institutional trial.钝性实体器官损伤后何时开始预防静脉血栓栓塞是安全的?一项前瞻性美国创伤外科学会多机构试验。
J Trauma Acute Care Surg. 2024 Feb 1;96(2):209-215. doi: 10.1097/TA.0000000000004163. Epub 2023 Oct 24.
3
Early venous thromboembolism prophylaxis in patients with trauma intracranial hemorrhage: Analysis of the prospective multicenter Consortium of Leaders in Traumatic Thromboembolism study.
创伤性颅内出血患者的早期静脉血栓栓塞预防:前瞻性多中心创伤性血栓栓塞领导者联盟研究分析。
J Trauma Acute Care Surg. 2023 Nov 1;95(5):649-656. doi: 10.1097/TA.0000000000004007. Epub 2023 Jun 12.
4
Angioembolization in Severe Pelvic Trauma is Associated with Venous Thromboembolism.严重骨盆创伤中的血管栓塞术与静脉血栓栓塞症有关。
J Surg Res. 2023 Mar;283:540-549. doi: 10.1016/j.jss.2022.10.054. Epub 2022 Nov 25.
5
Pharmaceutical Venous Thrombosis Prophylaxis in Critically Ill Traumatic Brain Injury Patients.重症创伤性脑损伤患者的药物性静脉血栓预防
Neurotrauma Rep. 2022 Jan 7;2(1):4-14. doi: 10.1089/neur.2021.0037. eCollection 2022.
6
Phlegmasia Cerulea Dolens, a Deadly Complication of Deep Vein Thrombosis: Case Report and Review of Literature.股青肿,一种深静脉血栓形成的致命并发症:病例报告及文献综述
Cureus. 2021 Nov 26;13(11):e19927. doi: 10.7759/cureus.19927. eCollection 2021 Nov.
7
Association of Venous Thromboembolism Prophylaxis After Neurosurgical Intervention for Traumatic Brain Injury With Thromboembolic Complications, Repeated Neurosurgery, and Mortality.颅脑创伤后神经外科干预后静脉血栓栓塞预防与血栓栓塞并发症、再次神经外科手术和死亡率的关系。
JAMA Surg. 2022 Mar 1;157(3):e215794. doi: 10.1001/jamasurg.2021.5794. Epub 2022 Mar 9.
8
American Association for the Surgery of Trauma/American College of Surgeons-Committee on Trauma Clinical Protocol for inpatient venous thromboembolism prophylaxis after trauma.美国创伤外科学会/美国外科医师学会创伤委员会创伤后住院患者静脉血栓栓塞症预防的临床方案。
J Trauma Acute Care Surg. 2022 Mar 1;92(3):597-604. doi: 10.1097/TA.0000000000003475.
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Optimal timing of venous thromboembolic chemoprophylaxis initiation following blunt solid organ injury: meta-analysis and systematic review.钝性实性器官损伤后开始静脉血栓栓塞化学预防的最佳时机:荟萃分析与系统评价
Eur J Trauma Emerg Surg. 2022 Jun;48(3):2039-2046. doi: 10.1007/s00068-021-01783-0. Epub 2021 Sep 18.
10
Early Chemoprophylaxis Against Venous Thromboembolism in Patients With Traumatic Brain Injury.创伤性脑损伤患者静脉血栓栓塞的早期化学预防
Am Surg. 2022 Feb;88(2):187-193. doi: 10.1177/0003134820983171. Epub 2021 Jan 27.