神经外科术后静脉栓塞症发病率及早期诊断  

Prevalence and eraly diagnosis of postoperative venous thromboembolism in neurosurgical patients

作　　者：汪璟[1] 鲁晓杰[1] 苗增利[1] 陈开来[1] 

机构地区：[1]南京医科大学附属无锡第二医院神经外科,214002

出　　处：《临床神经外科杂志》2013年第4期229-231,共3页Journal of Clinical Neurosurgery

摘　　要：目的对神经外科术后患者静脉栓塞症(深静脉血栓和肺栓塞)发病率及早期诊断进行前瞻性研究。方法 37例神经外科术后患者均按照静脉血栓预防指南进行了弹力袜和(或)四肢间隙气动压迫的预防性治疗。在术后平均12 d进行血管彩色超声检查,并通过增强CT扫描明确诊断。结果本组研究中下肢深静脉血栓发生率为13.5%,在发生深静脉血栓患者中肺栓塞发生率为60%,所有静脉血栓患者在临床上均没有症状。结论在神经外科术后患者中静脉血栓症的发病率很高,在采用了预防措施后部分患者依然不能避免,早期预防和早期发现对于减少神经外科术后静脉栓塞症非常重要。Objective To study the prevalence of venous thromboembolism （VTE） in neurosurgieal patients. Method 37 patients were screened by uhrasonography for deep vein thrombosis（DVT） in the lower extremities at an average of 12 days postoperatively. All patients received standard thromboprophylaxis using graded compression stocking with/without intermittent pneumatic compression following the VTE prevention guidelines. Definitive diagnosis of venous thromboembolism was made by contrast-enhanced whole-body eomputed tomography. Results Prevalence of deep vein thrombosis of the lower legs was 13.5%. Incidence of pulmonary embolism was 60% in patients having deep vein thrombosis. All patients having venous thromboembolism were asymptomatic. Conclusions This study showed the prevalence of asymptomatic VTE in the high- risk patients was as high as 20%. Moreover, silent PE occurred in these patients even though they received standard thromboprophylaxis using CS and IPC. The best treatment for VTE is prevention and pharmacological prophylaxis should be considered for patients with high risk of VTE.

关 键 词：静脉栓塞 肺栓塞 神经外科 脑肿瘤 

分 类 号：R651.1[医药卫生—外科学]