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神经外科静脉血栓相关治疗进展

Advances in the treatment of venous thromboembolism in the neurosurgery department

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静脉血栓在神经外科的治疗中是一类常见的伴随疾病,可导致致死性肺栓塞危及患者的生命健康.由于神经外科疾病的特殊性,通常伴随高危的出血风险,与静脉血栓的治疗背道而驰.虽然目前已有大量的观察性研究及Meta分析支持创伤性脑损伤及脑出血等颅内出血性疾病在出血稳定后早期启动抗凝预防或治疗的可行性,但缺乏高质量临床研究,因此目前神经外科医师在静脉血栓的药物预防及抗凝治疗方面仍偏保守.静脉血栓预防治疗时机、监测及何时停用等情况仍需高质量研究来确定.
Venous thromboembolism is a common comorbidity in neurosurgery department that can lead to life-threatening pulmonary embolism,endangering patient health.The unique characteristics of neurosurgical conditions often present a high risk of bleeding,which complicates the treatment of venous thrombosis.Although numerous observational studies and meta-analyses support the feasibility of initiating early anticoagulation prevention or treatment after hemorrhage stabilization in intracranial hemorrhagic conditions such as traumatic brain injury and cerebral hemorrhage,there is a lack of high-quality clinical research.As a result,neurosurgeons tend to adopt a conservative approach regarding pharmacological prophylaxis and anticoagulant treatment for venous thromboembolism.Key aspects such as the timing of prevention,monitoring,and discontinuation of treatment still require high-quality research to establish definitive guidelines.

Venous thromboembolismCerebral hemorrhageBrain neoplasmsWounds and injuriesAnticoagulantsHeparin,low-molecular-weightReview

泮旭峰、吴蓉、柴海飞、汪杰、胡小铭

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浙江省台州医院神经外科,台州 317000

临海市第一人民医院内科,临海 317000

静脉血栓栓塞 脑出血 脑肿瘤 创伤和损伤 抗凝药 肝素,低分子量 综述

浙江省台州市科技局科技计划(B类)

20ywb15

2024

中国基层医药
中华医学会,安徽医科大学

中国基层医药

影响因子:1.003
ISSN:1008-6706
年,卷(期):2024.31(9)