神经外科患者下肢静脉血栓的防治体会

Prevention and treatment of lower extremity venous thrombosis in Department of Neurosurgery

目的探讨神经外科住院患者下肢静脉血栓症的防治策略。方法为了减少患者下肢静脉血栓形成,防止肺栓塞发生,本研究选取2016年4月至2016年10月济宁医学院附属医院神经外科收治的672例患者作为观察组,对所有患者分期风险评估,并进行早期机械和药物综合防治,观察总结患者临床资料、防治措施和疗效,并将防治策略调整前2015年10月至2016年3月住院的652例患者的相应资料作为对照组进行比较。结果观察组发生下肢静脉血栓35例(5.20%),肺栓塞2例(0.31%),对照组发生下肢静脉血栓59例(9.05%),无肺栓塞病例发生,观察组下肢静脉血栓和肺栓塞的发生率明显低于对照组,差异具有统计学意义(P<0.01)。结论神经外科疾病下肢静脉血栓的发生率高,医务人员应高度重视,早期机械预防和药物防治,可显著降低深静脉血栓和肺栓塞的风险,而且对血肿扩大和死亡率没有影响。

Objective To explore the prevention and treatment strategy of venous thrombosis of lower extremity in hospitalized neurosurgery. Methods In order to reduce the incidence of venous thrombosis in the lower limbs and prevent the occurrence of pulmonary embolism, 672 inpatients treated in our hospital from April to October in 2016, were selected as the observation group. All patients were assessed for risk assessment and early mechanical and drug comprehensive prevention. The clinical data, control measures and curative effect of the patients were observed and compared with the data of 652 patients in the first 6 months after the improvement of the preventive measures as the control group. Results In the observation group, 35 patients had lower extremity venous thrombosis, the incidence rate was 5.20%, 2 cases of pulmonary embolism, the incidence rate was 0.31%; there were 59 patients with lower extremity venous thrombosis in the control group, the incidence rate was 9.05%, no cases of pulmonary embolism. The incidence of venous thrombosis and pulmonary embolism in the observation group was significantly lower than that in the control group （P〈0.01）. Conclusion The incidence of venous thrombosis in the lower limb of neurosurgical diseases is high. Medical personnel should attach great importance to it. Early mechanical prophylaxis and drug prevention can significantly reduce the risk of deep vein thrombosis and pulmonary embolism and have no effect on hematoma enlargement and mortality.