成人创伤性脑损伤患者静脉血栓栓塞症预防的最佳证据总结

Summary of the Best Evidence for the Prevention of Venous Thromboembolism in Adults with Traumatic Brain Injury

目的检索、提取和汇总成人创伤性脑损伤患者静脉血栓栓塞症(VTE)预防的最佳证据,为临床实践提供循证依据。方法系统检索中英文数据库、国内外相关指南及专业学会或协会网站中成人创伤性脑损伤患者VTE预防的相关文献。由两名研究人员独立筛选文献、评价文献质量并提取证据。结果共纳入22篇文献,包括3篇临床决策、8篇专家共识、11篇指南。汇总形成评估、筛查、基础预防、机械预防、药物预防、下腔静脉过滤器应用等6个方面共29条证据。结论临床医护人员应结合患者的病情及实际需求,充分考虑证据的可行性和适用性,同时可以选择合适的证据转化模式,并建立相应的审查指标或评价方法,以规范成人创伤性脑损伤患者VTE防治流程。

Objective To retrieve,extract and summarize the best evidence for the prevention of venous thromboembolism(VTE)in adults with traumatic brain injury(TBI),and provide evidence for clinical practice.Methods Literature on prevention of VTE in adult patients with TBI was systematically searched in Chinese and English databases,domestic and foreign guidelines and websites of professional societies or associations.Two researchers independently screened the literature,evaluated the quality of the literature and extracted the evidence.Results A total of 22 articles were included,including 3 clinical decisions,8 expert consensus,and 11 guidelines.A total of 29 pieces of evidence were collected from 6 aspects,including evaluation,screening,basic prevention,mechanical prevention,drug prevention,and application of inferior vena cava filter.Conclusion Clinical medical staff should fully consider the feasibility and applicability of evidence based on the patient's condition and actual needs.Furthermore,they can select appropriate evidence transformation mode and establish corresponding review indicators or evaluation methods to promote the standardization of VTE prevention and treatment process in adult TBI patients.