CAJ | 학술논문

目的评价自发性脑出血(spontaneous intracerebral hemorrhage,sICH)患者早期皮下注射小剂量低分子肝素(low molecular weight heparin,LMWH)那屈肝素预防深静脉血栓形成(deep vein thrombosis,DVT)的安全性.方法纳入早期使用那屈肝素或下肢间歇式充气加压装置(intermittent pneumatic compression,IPC)预防DVT的急性sICH患者.那屈肝素组从入院后第4天开始连续10 d皮下注射那屈肝素0.4 ml/d,IPC组使用IPC治疗.入院后第3天、第5天和第14天复查头颅CT评估血肿体积变化,记录治疗过程中的出血事件,彩色多普勒超声检查下肢DVT.结果共纳入早期使用那屈肝素或IPC预防DVT的急性sICH患者94例,那屈肝素组41例,IPC组53例.共有14例发生下肢DVT,其中那屈肝素组5例(12.2％),IPC组9例(17.0％),但2组DVT发生率差异无统计学意义(x2 =0.418,P=0.518).治疗期间所有患者均未出现颅内血肿增大和再出血.结论 sICH患者早期皮下注射小剂量那屈肝素预防DVT是安全的.
목적 평개자발성뇌출혈(spontaneous intracerebral hemorrhage,sICH)환자조기피하주사소제량저분자간소(low molecular weight heparin,LMWH)나굴간소예방심정맥혈전형성(deep vein thrombosis,DVT)적안전성.방법 납입조기사용나굴간소혹하지간헐식충기가압장치(intermittent pneumatic compression,IPC)예방DVT적급성sICH환자.나굴간소조종입원후제4천개시련속10 d피하주사나굴간소0.4 ml/d,IPC조사용IPC치료.입원후제3천、제5천화제14천복사두로CT평고혈종체적변화,기록치료과정중적출혈사건,채색다보륵초성검사하지DVT.결과 공납입조기사용나굴간소혹IPC예방DVT적급성sICH환자94례,나굴간소조41례,IPC조53례.공유14례발생하지DVT,기중나굴간소조5례(12.2％),IPC조9례(17.0％),단2조DVT발생솔차이무통계학의의(x2 =0.418,P=0.518).치료기간소유환자균미출현로내혈종증대화재출혈.결론 sICH환자조기피하주사소제량나굴간소예방DVT시안전적.
Objective To assess the safety of early subcutaneous injection of a low-dose low molecular weight heparin (LMWH) nadroparin for prevention of deep vein thrombosis (DVT) in patients with spontaneous intracerebral hemorrhage (sICH).Methods The patients with sICH who early using nadroparin or lower limb intermittent pneumatic compression (IPC) for prevention of DVT were enrolled.A nadroparin group continuously injected nadroparin 0.4 ml/d subcutaneously for 10 days at day 4 after admission and an IPC group used lower limb IPC.Head CT was reexamined and hematoma volume changes were evaluated at day 3,5,and 14 after admission.The hemorrhagic events during the course of treatment were documented,and the lower limb DVT was examined by color Doppler sonography.Results A total of 94 patients with acute sICH (n =41 in the nadroparin group,n =53 in the IPC group) who early use of nadroparin or IPC for prevention of DVT were enrolled.Fourteen patients had lower limb DVT,5 (12.2％) of them were in the nadroparin group and 9 (17.0％) of them were in the IPC group.However,there was no significant difference in the incidence of DVT between the two groups (x2 =0.418; P =0.518).During the treatment,no patient experienced increased intracranial hematoma and rebleeding.Conclusion Early subcutaneous injection of low-dose nadroparin for the prevention of DVT in patients with sICH is safe.