[烧伤中的静脉血栓栓塞:发生率和风险因素]。

Annals of burns and fire disasters Pub Date : 2024-09-30 eCollection Date: 2024-09-01
H Ben Khalifa, A Mokline, H Fraj, S Zarrouk, I Eljemi, B Gasri, M Ben Saad, A A Messadi
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引用次数: 0

摘要

烧伤患者的静脉血栓栓塞性疾病(VTE)是一种诊断不足且可能很严重的并发症。其发病率因研究而异。这项回顾性和描述性研究在突尼斯的一个烧伤重症监护室进行,历时 22 个月(2021 年 1 月 1 日至 2022 年 10 月 30 日),共收治了 785 名患者(发生率为 3%),其中有 24 名患者出现血栓栓塞并发症:肺栓塞 15 例,深静脉血栓形成(DVT)9 例。患者的平均年龄为 43.8 岁,男女性别比为 2:1。三分之二的患者(17 人)有病史:高血压(3 人)、糖尿病(2 人)和肿瘤(2 人)。三名患者为肥胖。平均总面积为 29%。19名患者(79%)的烧伤涉及下肢。VTE 的平均发病时间为 27.8 天。1/2的病例出现急性呼吸困难,1/3的病例出现心动过速。5名患者出现缺氧-低碳酸血症。确诊方法包括:胸部血管扫描(14 例)、肺部闪烁扫描(1 例)、下肢静脉多普勒超声(2 例)和下肢静脉扫描(7 例)。在我们的研究中,与血栓栓塞风险相关的因素有TBSA 20% - 39% (p=0,029; RR=4)、下肢受累 (p=0,068)、导管插入时间≥7 天 (p=0,048; RR=3)、导管数量大于 1 (p=0,01; RR=3)。13例患者的预后良好,11例患者死亡。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[VENOUS THROMBO-EMBOLISM IN BURNS: INCIDENCE AND RISK FACTORS].

Venous thromboembolic disease (VTE) in burn patients is an under-diagnosed and potentially serious complication. Its incidence varies according to studies performed. This retrospective and descriptive study conducted in an intensive burn care department in Tunisia over a period of 22 months (January 1, 2021 to October 30, 2022) included 24 patients who presented a thromboembolic complication among a total of 785 admissions (incidence of 3%): pulmonary embolism in 15 cases and deep venous thrombosis (DVT) in 9 cases. The mean age of the patients was 43.8 years, with a male:female sex ratio of 2:1. Two thirds of patients (n=17) had a pathological history: hypertension (n=3); diabetes (n=2) and neoplasia (n=2). Three patients were obese. The average TBSA was 29%. Burns involved lower limbs in 19 patients (79%). The mean time to onset of VTE was 27.8 days. Acute dyspnea was present in 1/2 of cases and tachycardia in 1/3 of cases. The association hypoxia-hypocapnia was found in 5 patients. The diagnosis was confirmed by: thoracic angioscan (n=14), pulmonary scintigraphy (n=1), venous Doppler ultrasound of the lower limbs (n=2) and phleboscan of lower limbs (n=7). Factors correlated with thromboembolic risk in our study were: TBSA 20% - 39% (p=0,029; RR=4), with lower limb involvement (p=0,068), catheterization duration ≥7 days (p=0,048; RR=3) and number of catheters >1 (p=0,01; RR=3). The outcome was favorable in 13 patients and fatal in 11 patients.

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