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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Compression Stockings and the Prevention of Symptomatic Venous Thromboembolism: Data From the Tinzaparin in Acute Ischemic Stroke Trial
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Compression Stockings and the Prevention of Symptomatic Venous Thromboembolism: Data From the Tinzaparin in Acute Ischemic Stroke Trial

机译：压力袜和症状性静脉血栓栓塞的预防：廷扎肝素在急性缺血性卒中试验中的数据

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Background: Venous thromboembolism (VTE) is a well-recognized and preventable complication of acute stroke. Although graduated compression stockings reduce the risk of VTE for patients undergoing operation, their benefit in acute stroke remains uncertain. Methods: The relationship between symptomatic VTE (sVTE) and use of stockings using observational data from the Tinzaparin in Acute Ischemic Stroke Trial, which compared 10 days of treatment with tinzaparin (175 IU/kg~(-1) or 100 IU/kg~(-1)) with aspirin (300mg), was assessed using logistic regression adjusted for known VTE risk factors and treatment. Results: sVTE Occurred in 28 patients (1.9%; 18 with deep vein thrombosis and 13 with pulmonary embolism) within 15 days of enrollment in 1479 patients. Patients wearing one or two stockings for any period of time during the first 10 days (n=803) had a nonsignificant increase (odds ratio 2.45, 95% confidence interval 0.95-6.32) in the risk of sVTE, In contrast, those wearing bilateral stockings for 10 days (n = 374) had a nonsignificant reduction in the odds of sVTE as compared with those who wore no stockings or wore them for less than 10 days (odds ratio 0.65, 95% confidence interval 0.26-1.65). Mild stroke and treatment with tinzaparin were associated with a reduced risk of VTE. Conclusions: Bilateral graduated compression stockings may reduce the incidence of VTE by one third for patients with acute ischemic stroke. However, the uncertainty in this finding, low frequency of sVTE, potential for stockings to cause harm, and cost of stockings highlight the need for a large randomized controlled trial to examine the safety and efficacy of stockings in acute stroke.
机译：背景：静脉血栓栓塞症（VTE）是急性卒中的一种公认且可预防的并发症。尽管渐进的压力袜降低了手术患者的VTE风险，但他们在急性中风中的获益仍不确定。方法：使用Tinzaparin在急性缺血性卒中试验中的观察数据，对症状性VTE（sVTE）与长袜的使用之间的关系进行比较，结果比较了Tinzaparin（175 IU / kg〜（-1）或100 IU / kg〜 （-1））服用阿司匹林（300mg），并采用针对已知VTE危险因素和治疗进行调整的逻辑回归进行评估。结果：1479名患者入组后15天内发生了28例sVTE（1.9％;深静脉血栓形成18例，肺栓塞13例）。在前10天内的任何时间段内，穿一件或两件长筒袜的患者（n = 803）患sVTE的风险无明显增加（优势比2.45，95％置信区间0.95-6.32）。与不穿袜子或穿不超过10天的袜子相比，穿10天（n = 374）的袜子的sVTE几率无显着降低（赔率0.65，95％置信区间0.26-1.65）。轻度卒中和丁扎肝素治疗可降低VTE风险。结论：急性缺血性卒中患者的双侧渐进式加压袜可将VTE的发生率降低三分之一。但是，这一发现的不确定性，sVTE的频率低，长袜可能造成伤害以及长袜的成本突出表明，需要进行一项大型随机对照试验，以检查长袜在急性卒中中的安全性和有效性。

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