低分子肝素、间歇性气压治疗预防颅脑创伤患者下肢深静脉血栓形成的临床分析

Clinical analysis on the effect of low molecular weight heparin and intermittent pneumatic compression against deep venous thrombosis following traumatic brain injury

目的探讨低分子肝素、间歇性气压治疗对颅脑创伤患者下肢深静脉血栓(DVT)形成的预防效果。方法回顾分析我科2010年3月～2013年3月682例颅脑创伤患者临床资料。有148例应用低分子肝素(LMWH)药物预防;173例行间歇性气压治疗(IPC)物理预防;169例行LMWH、IPC联合预防;有192例未实施LMWH、IPC预防。下肢深静脉彩超或下肢CTV诊断DVT。结果 LMWH药物预防组,DVT19例(12.83%);IPC预防组,DVT 23例(13.29%);LMWH、IPC联合预防组,DVT 14例(8.28%);未实施LMWH、IPC预防组,DVT 38例(19.80%)。LMWH、IPC联合预防组、LMWH预防组、IPC预防组DVT发生率明显低于未实施LMWH、IPC预防组(P<0.05);LMWH、IPC联合预防组DVT发生率明显低于LMWH预防组或IPC物理预防组(P<0.05)。结论 LMWH、IPC对预防颅脑创伤患者下肢深静脉血栓形成有一定的临床疗效,且LMWH、IPC联合预防效果更好。

Objective To explore the efficacy and safety of low molecular -weight heparin （ LMWH） and intermittent pneumatic compression （ IPC） against deep venous thrombosis （ DVT） following traumatic brain injury （TBI）.Methods The clinical data of 682 patients with TBI from Mar.2010 to Mar.2013 were analyzed retro-spectively.In those cases,148 cases received LMWH injection,173 cases received IPC prevention,169 cases re-ceived LMWH and IPC ,192 cases did not receive LMWH or IPC prevention .DVT was diagnosed by color duplex ultrasonography or computed tomo-venography（CTV）.Results There were 19 cases of DVT （12.83%）,23 cases of DVT （13.29%）,14 cases of DVT （8.28%） and 38 cases of DVT （19.80%） in the group of LMWH preven-tion,group of IPC prevention,group of LMWH＋IPC prevention and group of non-preventive measure,respectively. The incidence of DVT in group 1,2 and 3 was significantly lower than that in group 4 （P〈0.05）.The incidence of DVT in group 3 was significantly lower than that in group 1 or 2（P〈0.05）.Conclusion LMWH and IPC are ef-fective in preventing DVT following TBI .Meanwhile ,application of LMWH in combined with IPC can achieve better efficacy.