脊髓损伤患者静脉血栓性疾病防治的研究进展

Advances in the prevention and treatment of venous thrombotic diseases after spinal cord injury

脊髓损伤患者为住院患者中静脉血栓栓塞症(venous thrombosis embolism,VTE)的高危人群。VTE是住院患者非预期死亡和围手术期意外死亡的重要病因之一,因此脊髓损伤伴VTE患者值得重点关注。近年学者们对VTE的危险因素、流行病学特点、发病机制及预防等都有更深入了解,对于静脉血栓的治疗也有更全面而深入的认识,包括基础预防、药物预防及治疗、介入手术治疗、康复治疗等,无创性检查、治疗性新技术的出现以及新型口服抗凝溶栓药的研发也极大地推动了VTE的防治。同时,对于VTE的防治体系建设也已从单学科工作逐步发展到多学科、多职系、医患共同合作模式,从以科室为主导的临床综合管理模式,改变为以医院甚至更高级别职能部门为主导的多层级管理模式,这些措施都不同程度地进一步优化了静脉血栓临床防治管理工作。

Spinal cord injury(SCI) patients are high-risk groups of hospitalized patients with venous thrombosis embolism(VTE).VTE is one of the important causes of inpatients’ unexpected death and perioperative accidental death,so SCI patients with VTE deserve special attention.In recent years,the risk factors,epidemiological characteristics,pathogenesis,and prevention of VTE have been further understood.We also have a more comprehensive and in-depth understanding of the treatment of venous thrombosis,including general prevention,drug,interventional surgery,rehabilitation,etc.Non-invasive examination,new therapeutic technologies,and new oral anticoagulant drugs have also greatly promoted the prevention and treatment of VTE.Meanwhile,prevention system of VTE has been developed from single subject work gradually to the multidisciplinary,multiple grades and doctor-patient cooperation mode,is no longer just dominated by clinical departments,but dominated by hospitals and even higher level department,and a more scientific and effective management mode has being under construction,all of these will further optimize the clinical prevention and treatment of venous thrombosis.