重型颅脑损伤患者术后下肢深静脉血栓危险因素的范围综述

doi:10.3761/j.issn.2096-7446.2026.03.021

中华急危重症护理杂志 ›› 2026, Vol. 7 ›› Issue (3): 373-378.doi: 10.3761/j.issn.2096-7446.2026.03.021

重型颅脑损伤患者术后下肢深静脉血栓危险因素的范围综述

莫敏玲¹(), 曾谷清¹^,^*(), 张亚娟², 翟大红², 李晓珊¹, 朱颖¹

¹ 南华大学护理学院湖南省衡阳市 421001
² 上海交通大学医学院附属第六人民医院护理部上海市 200233

收稿日期:2025-05-06 出版日期:2026-03-10 发布日期:2026-03-02
通讯作者: 曾谷清 E-mail:minlingm218@163.com;zengguqing0123@163.com
作者简介:莫敏玲：女，本科（硕士在读），副主任护师，E-mail：minlingm218@163.com
基金资助:
上海交通大学医学院护理学科建设项目(SJTUHLXK2023)

Risk factors for lower extremity deep vein thrombosis in patients with severe traumatic brain injury after surgery：a scoping review

MO Minling¹(), ZENG Guqing¹^,^*(), ZHANG Yajuan², ZHAI Dahong², LI Xiaoshan¹, ZHU Ying¹

¹ School of Nursing， University of South China，Hengyang， Hunan Province 421001， China
² Nursing Department， Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine， Shanghai 200233， China

Received:2025-05-06 Online:2026-03-10 Published:2026-03-02
Contact: ZENG Guqing E-mail:minlingm218@163.com;zengguqing0123@163.com
Supported by:
Nursing Discipline Construction Project of Shanghai Jiao Tong University School of Medicine(SJTUHLXK2023)

1. 图1 文献筛选流程图.pdf(51KB)

摘要/Abstract

摘要：

目的整合重型颅脑损伤患者术后下肢深静脉血栓的危险因素，筛选核心预测变量，以指导重型颅脑损伤患者特异性风险预测工具开发。方法遵循系统评价和范围综述的首选报告条目框架，系统检索PubMed、Cochrane Library、中国知网等8个中英文数据库，检索时限为建库至2024年12月12日。按参与者-概念-背景框架构建研究问题，两名研究者独立完成文献筛选与资料提取，结合频次与临床适用性评估变量优先级。结果共纳入13篇文献，提取危险因素37项。高频因素（频率≥2次）包括以下15项。①人口学特征因素：高龄、高体质指数。②创伤相关指标：格拉斯哥昏迷评分低、重症监护病房住院时间长。③凝血功能标志物：D-二聚体水平升高、凝血酶原时间<12 s。④合并症：高血压、糖尿病、慢性肺部疾病、肺炎/肺部感染。⑤医源性暴露因素：机械通气、深静脉置管、术后卧床>1周、输血、使用脱水类药物。结论重型颅脑损伤患者术后下肢深静脉血栓风险受多维度因素影响，高频变量可为模型构建提供核心参数。当前证据存在地域偏倚及治疗性因素研究不足，建议未来通过多中心研究完善标准化定义与动态监测。

关键词: 重型颅脑损伤, 下肢深静脉血栓, 危险因素, 范围综述

Abstract:

Objective To synthesize the risk factors for lower extremity deep vein thrombosis（LEDVT） in patients with severe traumatic brain injury（sTBI） after surgery and identify core predictive variables to guide the development of an sTBI-specific risk prediction tool.Methods According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines，eight English and Chinese databases （PubMed，Cochrane Library，CNKI，etc.） were systematically searched from database inception to December 2024. Research questions were formulated according to the Participants-Concept-Context framework. Two researchers independently screened literature，extracted data，and prioritized variables based on frequency and clinical applica-bility.Results Thirteen studies were included，yielding 37 risk factors. Fifteen high-frequency factors （occurrence≥2 times） were identified：①Demographic characteristics：advanced age，elevated body mass index；②Trauma-related indicators：low Glasgow Coma Scale（GCS） score，prolonged intensive care unit stay；③Coagulation biomarkers：elevated D-dimer levels，prothrombin time<12 seconds；④Comorbidities：hypertension，diabetes，chronic pulmonary disease，pneumonia/pulmonary infection；⑤Iatrogenic exposures：mechanical ventilation，central venous catheterization，postoperative bedrest >1 week，blood transfusion，use of dehydrating agents.Conclusion LEDVT risk in sTBI patients is influenced by multidimensional factors，high-frequency variables identified in this review can serve as core parameters for model construction. Current evidence exhibits geographical bias and insufficient investigation into therapeutic factors. Future multicenter studies are recommended to refine standardized definitions and implement dynamic monitoring strategies.

Key words: Severe Traumatic Brain Injury, Lower Extremity Deep Vein Thrombosis, Risk Factors, Scoping Review

莫敏玲, 曾谷清, 张亚娟, 翟大红, 李晓珊, 朱颖. 重型颅脑损伤患者术后下肢深静脉血栓危险因素的范围综述[J]. 中华急危重症护理杂志, 2026, 7(3): 373-378.

MO Minling, ZENG Guqing, ZHANG Yajuan, ZHAI Dahong, LI Xiaoshan, ZHU Ying. Risk factors for lower extremity deep vein thrombosis in patients with severe traumatic brain injury after surgery：a scoping review[J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(3): 373-378.

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重型颅脑损伤患者术后下肢深静脉血栓危险因素的范围综述

Risk factors for lower extremity deep vein thrombosis in patients with severe traumatic brain injury after surgery：a scoping review

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