중증외상 환자에서 심부정맥혈전 발생에 관한 고찰
분야
의약학 > 외과학
저자
김상년 ( Sang Nyun Kim ) , 이동언 ( Dong Un Lee ) , 이범철 ( Bum Chul Lee ) , 박정배 ( Jung Bae Park ) , 신수정 ( Su Jeong Shin )
발행기관
대한외상학회
간행물정보
대한외상학회지 2012년, 제25권 제4호, 109~114페이지(총6페이지)
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19400636.pdf [무료 PDF 뷰어 다운로드]
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    영문초록
    Purpose: Deep vein thrombosis and pulmonary thromboembolism are major causes of death after severe multiple trauma. Although various means of prevention have been presented and utilized, still, there are no standard guidelines for anticoagulation of multiple trauma because of some contraindications. Methods: A retrospective study of adult major trauma patients whose injury severity scores (ISSs) were over 16 and who had visited one university hospital in Daegu city was performed. We compared some features of patients diagnosed DVT or PTE with those of patients without DVT by computed tomography or ultra sonography. Those features included accompanying various kinds of intracranial hemorrhages, possibility of ambulation, emergent operation, early transfusion, and suspicious symptoms. Results: The mean age of the 58 subjects included in this study was 50.9±17.2 years, the mean ISS was 22.7±6.0, and the mean hospital stay was 55.2±37.9 days. Ten(17.2%) patients had emergent surgery, and 44(75.9%) experienced delayed surgery. Early transfusion was needed in 34(58.6%) patients. Among the 18 patients diagnosed with DVT, accompanying intracranial hemorrhages were noted in 8(44.4%) patients; one of the 8 also had PTE. Among the same 18 patients, early transfusions were required in 11(61.1%) patients; one of the 11 also had PTE. Conclusion: The risk of DVT is increased in cases of severe multiple trauma, and many difficulties in applying anticoagulants are experienced. Though we need additional studies to decide proper prophylaxis for DVT and PTE, if the patient`s general condition permits, a screening test for DVT as soon as possible could be an effective method to reduce the possibility of a bad outcome. (J Trauma Inj 2012;25:109-114)
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