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早期那屈肝素预防脑出血患者深静脉血栓形成的安全性

ISSN号：1673-4165
期刊名称：《国际脑血管病杂志》
时间：0
分类：R543.6[医药卫生—心血管疾病;医药卫生—临床医学;医药卫生—内科学]
作者机构：[1]南京大学医学院附属鼓楼医院急诊科,210008, [2]南京医科大学鼓楼临床医学院急诊科,210008
相关基金：南京市科技发展项目（201303002）

作者：顾双双[1], 张均[1,2], 韩玲[1], 李瑾[1], 李启明[1], 钱健[1,2], 沙杜鹃[1,2]

关键词：脑出血, 静脉血栓栓塞, 肝素, 低分子量, 危险性评估, 那屈肝素, Cerebral Hemorrhage, Venous Thromboembolism, Heparin, Low-Molecular-Weight, Risk Assessment, Nadroparin

中文摘要：

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。方法纳人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10d皮下注射那屈肝素0．4ml／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（X^2=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。

英文摘要：

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 （slCH）. 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.llesults 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 DVI＂ 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 0（2 =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.

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