烧伤患者静脉血栓栓塞症的研究进展

石一芩; 刘蕾; 黎宁; 罗高兴; 李海胜

doi:10.3760/cma.j.cn501225-20220323-00083

烧伤患者静脉血栓栓塞症的研究进展

doi: 10.3760/cma.j.cn501225-20220323-00083

1.
陆军军医大学（第三军医大学）第一附属医院护理处，重庆　　400038
2.
陆军军医大学（第三军医大学）第一附属医院全军烧伤研究所，创伤、烧伤与复合伤国家重点实验室，重庆市疾病蛋白质组学重点实验室，重庆　　400038

基金项目:

陆军军医大学领军人才培养基金项目 4139Z2C1

军委后勤保障卫生局应用基础研究项目 2021758

详细信息

通讯作者:
刘蕾，Email：ttcrystalma@163.com

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出版历程
- 收稿日期: 2022-03-23

Research advances on venous thromboembolism in burn patients

1.
Nursing Department, the First Affiliated Hospital of Army Medical University (the Third Military Medical University), Chongqing 400038, China
2.
State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Burn Research, the First Affiliated Hospital of Army Medical University (the Third Military Medical University), Chongqing Key Laboratory for Disease Proteomics, Chongqing 400038, China

Funds:

Project of Training Fund for Leading Talents of Army Medical University 4139Z2C1

Applied Basic Research Project of the Logistics Support and Health Bureau of the Military Commission 2021758

More Information

Corresponding author: Liu Lei, Email: ttcrystalma@163.com

摘要

摘要: 静脉血栓栓塞症发病率高、致死率高、易漏诊误诊，已成为全球医务人员面临的严峻医疗问题。严重烧伤患者由于存在血液高凝状态、中心静脉置管、反复接受外科手术、长时间卧床等因素，是发生静脉血栓栓塞症的高风险人群。识别烧伤患者发生静脉血栓栓塞症的风险因素并有针对性地采取预防措施，是降低静脉血栓栓塞症发病率的关键，然而国内外还没有针对烧伤患者的静脉血栓风险评估工具和预防指南，各国学者仍在积极探索烧伤患者静脉血栓栓塞症的发生情况、影响因素和预防。该文就近年来烧伤患者发生静脉血栓栓塞症的现状、相关风险因素、风险评估和预防的研究进展进行综述，对该领域现存的问题和未来研究方向进行探讨。
- 烧伤 /
- 静脉血栓栓塞 /
- 风险因素 /
- 风险评估 /
- 预防
Abstract: Venous thromboembolism (VTE) has become a serious medical problem faced by medical personnel all over the world, due to its high incidence, high fatality, and easily missed and misdiagnosed. Patients with severe burns are at high risk for VTE due to the presence of blood hypercoagulability, central venous catheterization, repeatedly received surgical procedures, and prolonged bed rest. Identifying the risk factors of VTE in burn patients and taking targeted preventive measures are the key to reduce the incidence of VTE. However, there are no risk assessment tools or prevention guidelines for VTE in burn patients at home and abroad, and scholars from various countries are actively exploring the occurrence, influencing factors, and prevention of VTE in burn patients. This paper reviews the research progress of the occurrence situation, related risk factors, risk assessment, and prevention of VTE in burn patients in recent years, and discusses the existing problems and future research directions in this field.
- Burns /
- Venous thromboembolism /
- Risk factor /
- Risk assessment /
- Prevention
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参考文献(41)

[1]	中华医学会骨科学分会创伤骨科学组,中华医学会骨科学分会外固定与肢体重建学组,中国医师协会骨科医师分会创伤专家工作委员会,等.中国创伤骨科患者围手术期静脉血栓栓塞症预防指南(2021)[J].中华创伤骨科杂志,2021,23(3):185-192.DOI: 10.3760/cma.j.cn115530-20201228-00795.
[2]	邵翔,翟振国,王辰.医院相关性静脉血栓栓塞症[J].中华医学杂志,2018,98(46):3792-3794.DOI: 10.3760/cma.j.issn.0376-2491.2018.46.014.
[3]	LiuA,MinasianRA,ManiagoE,et al.Venous thromboembolism chemoprophylaxis in burn patients: a literature review and single-institution experience[J].J Burn Care Res,2021,42(1):18-22.DOI: 10.1093/jbcr/iraa143.
[4]	王艳琼,黄建琼,许学文,等.标准化静脉血栓栓塞症预防方案在烧伤患者中的应用研究[J].中国修复重建外科杂志,2019,33(6):726-729.DOI: 10.7507/1002-1892.201812061.
[5]	PannucciCJ,ObiAT,TimminsBH,et al.Venous thromboembolism in patients with thermal injury: a review of risk assessment tools and current knowledge on the effectiveness and risks of mechanical and chemical prophylaxis[J].Clin Plast Surg,2017,44(3):573-581.DOI: 10.1016/j.cps.2017.02.002.
[6]	PannucciCJ,OsborneNH,WahlWL.Venous thromboembolism in thermally injured patients: analysis of the National Burn Repository[J].J Burn Care Res,2011,32(1):6-12.DOI: 10.1097/BCR.0b013e318204b2ff.
[7]	AlthunayanTA,AlQarniSM,MohsenhWA,et al.Risk factors for thromboembolism in burn patients admitted to the burn unit at King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia[J].Saudi Med J,2019,40(10):1027-1031.DOI: 10.15537/smj.2019.10.23955.
[8]	MuraliL,KavithaY. A prospective study of incidence of deep vein thrombosis and outcome in hospitalised patients with burns in a tertiary care hospital, Warangal urban[J].J Evolution Med Dent Sci,2019,8(28):2288-2294.DOI: 10.14260/jemds/2019/501.
[9]	LiQ,BaT,WangLF,et al.Stratification of venous thromboembolism risk in burn patients by Caprini score[J].Burns,2019,45(1):140-145.DOI: 10.1016/j.burns.2018.08.006.
[10]	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.DOI: 10.3760/cma.j.issn.1009-2587.2016.03.010.
[11]	张伟,张俊峰,王觅,等.成年烧伤患者深静脉血栓的发生情况及危险因素[J].中华烧伤杂志,2020,36(1):54-57.DOI: 10.3760/cma.j.issn.1009-2587.2020.01.010.
[12]	AhujaRB,BansalP,PradhanGS,et al.An analysis of deep vein thrombosis in burn patients (part II): a randomized and controlled study of thrombo-prophylaxis with low molecular weight heparin[J].Burns,2016,42(8):1693-1698.DOI: 10.1016/j.burns.2016.08.007.
[13]	ZhouHM,XuSJ,WangL,et al.Influences of high-voltage electrical burns on the pulmonary microcirculation in rabbits[J].Clin Hemorheol Microcirc,2016,62(3):193-203.DOI: 10.3233/CH-141921.
[14]	张庆富,李勇,冯建科,等.高压电烧伤大鼠血小板流变行为变化及乌司他丁的干预效果[J].中华烧伤杂志,2017,33(12):744-749.DOI: 10.3760/cma.j.issn.1009-2587.2017.12.005.
[15]	郭弯弯,褚雅歆,乔蕊.血栓炎症反应的研究进展[J].临床检验杂志,2022,40(1):42-47.DOI: 10.13602/j.cnki.jcls.2022.01.10.
[16]	PannucciCJ,OsborneNH,JaberRM,et al.Early fasciotomy in electrically injured patients as a marker for injury severity and deep venous thrombosis risk: an analysis of the National Burn Repository[J].J Burn Care Res,2010,31(6):882-887.DOI: 10.1097/BCR.0b013e3181f93597.
[17]	陈恒利,彭康祖,要亚仙,等.麻醉因素对老年患者髋部骨折术后转归的影响:meta分析[J].中华麻醉学杂志,2019,39(12):1425-1429.DOI: 10.3760/cma.j.issn.0254-1416.2019.12.005.
[18]	GuptaE,SiddiqiFS,KunjalR,et al.Association between aspirin use and deep venous thrombosis in mechanically ventilated ICU patients[J].J Thromb Thrombolysis,2017,44(3):330-334.DOI: 10.1007/s11239-017-1525-x.
[19]	孙健平,薛汉中,张堃,等.术中输血对创伤骨科患者术后深静脉血栓形成的影响研究[J].中华创伤骨科杂志,2021,23(9):793-797.DOI: 10.3760/cma.j.cn115530-20210117-00028.
[20]	KasererA,RösslerJ,SlankamenacK,et al.Impact of allogeneic blood transfusions on clinical outcomes in severely burned patients[J].Burns,2020,46(5):1083-1090.DOI: 10.1016/j.burns.2019.11.005.
[21]	ChopraV,KaatzS,GrantP,et al.Risk of venous thromboembolism following peripherally inserted central catheter exchange: an analysis of 23,000 hospitalized patients[J].Am J Med,2018,131(6):651-660.DOI: 10.1016/j.amjmed.2018.01.017.
[22]	中华医学会烧伤外科学分会.严重烧伤患者深静脉置管操作和管理的全国专家共识(2020版)[J].中华烧伤杂志,2021,37(2):101-112.DOI: 10.3760/cma.j.cn501120-20201122-00487.
[23]	ChopraV,KaatzS,ConlonA,et al.The Michigan Risk Score to predict peripherally inserted central catheter-associated thrombosis[J].J Thromb Haemost,2017,15(10):1951-1962.DOI: 10.1111/jth.13794.
[24]	KokuboK,KuriharaY,KobayashiK,et al.Evaluation of the biocompatibility of dialysis membranes[J].Blood Purif,2015,40(4):293-297.DOI: 10.1159/000441576.
[25]	熊嫚,贺锐,赵晓珊,等.血液透析患者中心静脉置管后导管相关性血栓研究进展[J].成都医学院学报,2022,17(3):395-399.DOI: 10.3969/j.issn.1674-2257.2022.03.026.
[26]	ZhangZ,LeiJ,ShaoX,et al.Trends in hospitalization and in-hospital mortality from VTE, 2007 to 2016, in China[J].Chest,2019,155(2):342-353.DOI: 10.1016/j.chest.2018.10.040.
[27]	急性出血性凝血功能障碍诊治专家共识组,邵勉,薛明明,等.急性出血性凝血功能障碍诊治专家共识[J].中华急诊医学杂志,2020,29(6):780-787.DOI: 10.3760/cma.j.issn.1671-0282.2020.06.007.
[28]	王丁一,范国辉,吴司南,等.肾功能不全与静脉血栓栓塞症[J].中华结核和呼吸杂志,2022,45(2):204-208.DOI: 10.3760/cma.j.cn112147-20210728-00529.
[29]	OliveraPA,ZuilyS,KotzePG,et al.International consensus on the prevention of venous and arterial thrombotic events in patients with inflammatory bowel disease[J].Nat Rev Gastroenterol Hepatol,2021,18(12):857-873.DOI: 10.1038/s41575-021-00492-8.
[30]	WuJX,QingJH,YaoY,et al.Performance of age-adjusted D-dimer values for predicting DVT before the knee and hip arthroplasty[J].J Orthop Surg Res,2021,16(1):82.DOI: 10.1186/s13018-020-02172-w.
[31]	ISBI Practice Guidelines Committee,SubcommitteeAdvisory,SubcommitteeSteering.ISBI practice guidelines for burn care, part 2[J].Burns,2018,44(7):1617-1706.DOI: 10.1016/j.burns.2018.09.012.
[32]	GeertsWH,BergqvistD,PineoGF,et al.Prevention of venous thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition)[J].Chest,2008,133(6 Suppl): S381-453.DOI: 10.1378/chest.08-0656.
[33]	ShirolSS,KodaganurS,RaoMR,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.DOI: 10.4103/ijps.IJPS_179_15.
[34]	VermaakPV,D'AstaF,ProvinsJ,et al.Thromboprophylaxis in adult and paediatric burn patients: a survey of practice in the United Kingdom[J].Burns,2019,45(6):1379-1385.DOI: 10.1016/j.burns.2019.04.003.
[35]	TracyLM,CameronPA,SingerY,et al.Venous thromboembolism prophylaxis practice and its association with outcomes in Australia and New Zealand burns patients[J/OL].Burns Trauma,2021,9:tkaa044[2022-03-23].https://pubmed.ncbi.nlm.nih.gov/33654696/.DOI: 10.1093/burnst/tkaa044.
[36]	国际血管联盟中国分部护理专业委员会.住院患者静脉血栓栓塞症预防护理与管理专家共识[J].解放军护理杂志,2021,38(6):17-21.DOI: 10.3969/j.issn.1008-9993.2021.06.005.
[37]	董煜廷,徐建萍.Caprini血栓评估表临床使用局限性分析[J].护理学杂志,2020,35(4):104-107.DOI: 10.3870/j.issn.1001-4152.2020.04.104.
[38]	PengH,YueL,GaoH,et al.Risk assessment of deep venous thrombosis and its influencing factors in burn patients[J].J Burn Care Res,2020,41(1):113-120.DOI: 10.1093/jbcr/irz121.
[39]	谷思琪,皮红英,宋咪,等.机械预防深静脉血栓形成的机制及应用研究综述[J].解放军医学院学报,2021,42(12):1326-1329.DOI: 10.3969/j.issn.2095-5227.2021.12.019.
[40]	国家卫生健康委办公厅国家卫生健康委办公厅关于印发2021年国家医疗质量安全改进目标的通知 2022-03-23 http://www.gov.cn/zhengce/zhengceku/2021-02/22/5588240/files/7f3670bbe56d4eb2a30c591b832bbb01.pdf 国家卫生健康委办公厅.国家卫生健康委办公厅关于印发2021年国家医疗质量安全改进目标的通知[EB/OL].2021[2022-03-23].http://www.gov.cn/zhengce/zhengceku/2021-02/22/5588240/files/7f3670bbe56d4eb2a30c591b832bbb01.pdf.
[41]	朱丽筠,王磊,徐园,等.国外静脉血栓栓塞症预防研究的文献计量学分析[J].中华护理杂志,2021,56(12):1906-1910.DOI: 10.3761/j.issn.0254-1769.2021.12.025.