静脉血栓栓塞症在烧伤患者中的预防
|
摘要
静脉血栓发生的三大因素有血液的高凝状态、血管内皮的损伤和静脉血流的瘀滞。严重烧伤患者可能同时具备这三大因素,是发生静脉血栓的高危人群。静脉血栓栓塞症是住院患者可预防的、常见的致死性并发症。对于烧伤患者,及时有效的评估和监测,尽量避免长时间深静脉置管,鼓励卧床患者早期肢体活动和锻炼,并且预防性用药,是预防VTE的有效手段。
The three major causes of venous thrombosis are hypercoagulability of the blood, damage to the vascular endothelium and stasis of venous blood flow. Severe burn patients may have these three factors at the same time, which are the high-risk to get venous thrombosis. Venous thrombus embolism is a preventable and fatal complication in hospitalized patients. For burn patients, the effective managements of preventing VTE include effective evaluating and monitoring timely, trying to avoid long-term deep venous catheterization, encouraging early limb exercise in bedridden patients and preventive medication.
The three major causes of venous thrombosis are hypercoagulability of the blood, damage to the vascular endothelium and stasis of venous blood flow. Severe burn patients may have these three factors at the same time, which are the high-risk to get venous thrombosis. Venous thrombus embolism is a preventable and fatal complication in hospitalized patients. For burn patients, the effective managements of preventing VTE include effective evaluating and monitoring timely, trying to avoid long-term deep venous catheterization, encouraging early limb exercise in bedridden patients and preventive medication.
引文
[1]王爽,刘光晶,李小兵.烧伤后机体血液高凝状态的监测及其临床意义[J].医学综述,2015,21(2):284-285.
[2] PARK MS,OWEN BA,BALLINGER BA,et al.Quantification of hypercoagulable state after blunt trauma:microparticle and thrombin generation are increased relative to injury severity, while standard markers are not[J].Surgery,2012,151(6):831-836.
[3]张庆富.烧伤后微血管功能变化及其体液调节[J].中华损伤与修复杂志:电子版,2011,6(2):174-182.
[4]张红兵.严重烧伤防治深静脉血栓的研究进展(综述)[J].中国城乡企业卫生,2014,29(1):14-16.
[5]高凤英,习耀锋,郑明霞,等.烧伤患者深静脉血栓发生情况及其影响因素[J].中华烧伤杂志,2016,32(3):176-180.
[6]雷雨,刘宁,彭静.烧伤患者血栓易发因素的研究[J].中国现代医学杂志,2018,28(7):84-87.
[7]周奕,杨京华,刘双.622例急性肺栓塞患者的临床特点分析[J].心肺血管病杂志,2014,33(6):820-824.
[8]彭丁,习昕,刘双.D-二聚体检测在静脉血栓栓塞症诊断中应用的新进展[J].心肺血管病杂志,2015,34(5):422-424.
[9] AHUJA RB,BANSAL P,PRADHAN GS,et al.An analysis of deep vein thrombosis in burn patients(Part 1):comparison of D-dimer and Doppler ultrasound as screening tools[J].Burns,2016,42(8):1686-1692.
[10]叶春江,张元海,刘利平,等.86例特重烧伤患者血小板计数变化和深静脉血栓的预防[J].中国现代医生,2012,50(23):20-22.
[11]邓建文.凝血功能检测对烧伤患者下肢静脉血栓的预测价值[J].中国烧伤创疡杂志,2017,29(2):92-95.
[12] SHIROL SS,KODAGANUR S,RAO M,et al.The conundrum of deep vein thrombosis prophylaxis in burns in India and review of literature[J].Indian J Plast Surg,2017,50(3):288-294.
[13]范宝玉,王娟,赵海磊.皮下注射低分子肝素钙对烧伤植皮后深静脉血栓形成、创面愈合及感染率的影响[J].感染、炎症、修复,2017,18(3):141-144.
[14]黄晓东,许特.皮下注射低分子肝素钙预防烧伤植皮后深静脉血栓形成的效果评价[J].中国当代医药,2015,22(18):88-90.
[15]李彩红,刘红娟.低分子肝素钙在预防烧伤患者静脉血栓栓塞症高危人群中的临床应用[J].中国实用医药,2017,12(15):108-110.
[16]蒋南红,谢卫国,王晖,等.低分子量肝素对电烧伤大鼠血管损伤与炎症反应的影响[J].中华烧伤杂志,2014,30(2):128-133.
[17] AHUJA RB,BANSAL P,PRADHAN GS,et al.An analysis of deep vein thrombosis in burn patients(partⅡ):a randomized and controlled study of thrombo-prophylaxis with low molecular weight heparin[J].Burns,2016,42(8):1693-1698.
[18] BUSCHE MN,HEROLD C,KRAMER R,et al.Evaluation of prophylactic anticoagulation, deep venous thrombosis, and heparin-induced thrombocytopenia in 21 burn centers in Germany, Austria,and Switzerland[J].Ann Plast Surg,2011,67(1):17-24.
[19] BUSHWITZ J,LECLAIRE A,HE J,et al.Clinically significant venous thromboembolic complications in burn patients receiving unfractionated heparin or enoxaparin as prophylaxis[J].J Burn Care Res,2011,32(6):578-582.
[20]唐虹,施耘,阮建春.低分子肝素钙联合丹参注射液治疗对烧伤感染后深静脉血栓形成的预防作用研究[J].重庆医学,2016,45(29):4134-4136.
[21]傅勇,王宁宁,李家光,等.疏血通联合低分子肝素钙抗凝在特重度烧伤救治中的疗效观察[J].滨州医学院学报,2017,40(3):189-191.
[2] PARK MS,OWEN BA,BALLINGER BA,et al.Quantification of hypercoagulable state after blunt trauma:microparticle and thrombin generation are increased relative to injury severity, while standard markers are not[J].Surgery,2012,151(6):831-836.
[3]张庆富.烧伤后微血管功能变化及其体液调节[J].中华损伤与修复杂志:电子版,2011,6(2):174-182.
[4]张红兵.严重烧伤防治深静脉血栓的研究进展(综述)[J].中国城乡企业卫生,2014,29(1):14-16.
[5]高凤英,习耀锋,郑明霞,等.烧伤患者深静脉血栓发生情况及其影响因素[J].中华烧伤杂志,2016,32(3):176-180.
[6]雷雨,刘宁,彭静.烧伤患者血栓易发因素的研究[J].中国现代医学杂志,2018,28(7):84-87.
[7]周奕,杨京华,刘双.622例急性肺栓塞患者的临床特点分析[J].心肺血管病杂志,2014,33(6):820-824.
[8]彭丁,习昕,刘双.D-二聚体检测在静脉血栓栓塞症诊断中应用的新进展[J].心肺血管病杂志,2015,34(5):422-424.
[9] AHUJA RB,BANSAL P,PRADHAN GS,et al.An analysis of deep vein thrombosis in burn patients(Part 1):comparison of D-dimer and Doppler ultrasound as screening tools[J].Burns,2016,42(8):1686-1692.
[10]叶春江,张元海,刘利平,等.86例特重烧伤患者血小板计数变化和深静脉血栓的预防[J].中国现代医生,2012,50(23):20-22.
[11]邓建文.凝血功能检测对烧伤患者下肢静脉血栓的预测价值[J].中国烧伤创疡杂志,2017,29(2):92-95.
[12] SHIROL SS,KODAGANUR S,RAO M,et al.The conundrum of deep vein thrombosis prophylaxis in burns in India and review of literature[J].Indian J Plast Surg,2017,50(3):288-294.
[13]范宝玉,王娟,赵海磊.皮下注射低分子肝素钙对烧伤植皮后深静脉血栓形成、创面愈合及感染率的影响[J].感染、炎症、修复,2017,18(3):141-144.
[14]黄晓东,许特.皮下注射低分子肝素钙预防烧伤植皮后深静脉血栓形成的效果评价[J].中国当代医药,2015,22(18):88-90.
[15]李彩红,刘红娟.低分子肝素钙在预防烧伤患者静脉血栓栓塞症高危人群中的临床应用[J].中国实用医药,2017,12(15):108-110.
[16]蒋南红,谢卫国,王晖,等.低分子量肝素对电烧伤大鼠血管损伤与炎症反应的影响[J].中华烧伤杂志,2014,30(2):128-133.
[17] AHUJA RB,BANSAL P,PRADHAN GS,et al.An analysis of deep vein thrombosis in burn patients(partⅡ):a randomized and controlled study of thrombo-prophylaxis with low molecular weight heparin[J].Burns,2016,42(8):1693-1698.
[18] BUSCHE MN,HEROLD C,KRAMER R,et al.Evaluation of prophylactic anticoagulation, deep venous thrombosis, and heparin-induced thrombocytopenia in 21 burn centers in Germany, Austria,and Switzerland[J].Ann Plast Surg,2011,67(1):17-24.
[19] BUSHWITZ J,LECLAIRE A,HE J,et al.Clinically significant venous thromboembolic complications in burn patients receiving unfractionated heparin or enoxaparin as prophylaxis[J].J Burn Care Res,2011,32(6):578-582.
[20]唐虹,施耘,阮建春.低分子肝素钙联合丹参注射液治疗对烧伤感染后深静脉血栓形成的预防作用研究[J].重庆医学,2016,45(29):4134-4136.
[21]傅勇,王宁宁,李家光,等.疏血通联合低分子肝素钙抗凝在特重度烧伤救治中的疗效观察[J].滨州医学院学报,2017,40(3):189-191.