颅脑损伤患者深静脉血栓危险因素的Meta分析

Meta-Analysis of Risk Factors for Deep Venous Thrombosis in Patients with Traumatic Brain Injury

目的探讨颅脑损伤(TBI)患者深静脉血栓(DVT)的危险因素,为预防TBI患者发生DVT提供依据。方法利用计算机检索中英文数据库中关于TBI患者DVT发生危险因素的相关文献,检索时限为建库至2024年1月14日,由两位研究者筛选文献、提取资料并进行质量评价。结果共纳入14篇文献,Meta分析结果显示,年龄≥50岁、BMI>30 kg/m^(2)、GCS≤8分、糖尿病、高血压、呼吸机支持>4 d、住院总天数≥15 d、深静脉置管、凝血酶原时间短、D-二聚体升高是TBI患者发生DVT的危险因素(P<0.05)。结论TBI患者发生DVT的危险因素较多。医护人员需落实规范化DVT风险评估,关注高风险患者,采取针对性预防措施,如定期监测凝血指标、合理使用抗凝药物、鼓励早期下床活动、优化呼吸机使用策略及严格遵循无菌操作规范等;同时应构建TBI患者DVT风险预测模型,以有效降低DVT发生风险,提高患者预后和生活质量。

Objective To investigate the risk factors of deep venous thrombosis(DVT)in patients with traumatic brain injury(TBI),and to provide evidence for the prevention of DVT in patients with TBI.Methods The relevant literatures on the risk factors of DVT in patients with TBI were retrieved by computer from Chinese and English databases.The retrieval time was from the establishment of the database to January 14,2024.Two researchers screened the literature,extracted the data and evaluated the quality.Results A total of 14 articles were included.Meta-analysis results showed that age≥50 years old,BMI>30 kg/m^(2),GCS≤8 points,diabetes,hypertension,ventilator support>4 d,total hospitalization days≥15 d,deep vein catheterization,short prothrombin time,and elevated D-dimer were risk factors for DVT in TBI patients(P<0.05).Conclusion There are many risk factors for DVT in TBI patients.Medical staff should implement standardized DVT risk assessment,pay attention to high-risk patients,and take targeted preventive measures,such as regular monitoring of coagulation indicators,rational use of anticoagulants,encouragement of early ambulation,optimization of ventilator use strategies,and strict compliance with aseptic operation specifications.At the same time,medical institutions should construct a DVT risk prediction model for TBI patients so as to effectively reduce the risk of DVT and improve the prognosis and quality of life of patients.