摘要目的:探讨创伤性颅内出血患者治疗期间静脉血栓栓塞症(VTE)的发生情况及其相关影响因素。方法:回顾性分析2017年5月至2019年10月首都医科大学附属北京天坛医院神经外科收治的362例单纯创伤性颅内出血(排除多发伤)患者的临床资料。患者住院期间通过彩色多普勒超声或胸部螺旋CT断层扫描评估临床高危或高度疑似VTE的患者，并分为无VTE组和VTE组。采用单因素分析法和多因素logistic回归分析法分析VTE的发生情况及相关的危险因素和保护因素。结果:362例单纯创伤性颅内出血患者中，共有160例发生VTE，总体发生率为44.2%。多因素logistic回归分析结果显示，年龄(40～59岁， OR＝5.316，95% CI: 2.322～11.173；≥60岁， OR＝11.221，95% CI：4.935～25.518)、输血治疗( OR＝2.396，95% CI：1.413～4.063)是VTE发生的危险因素(均 P<0.05)。362例患者住院期间采用不同的预防VTE措施：其中158例(43.7%)主动或被动活动，104例(28.7%)穿戴弹力袜，100例(27.6%)使用下肢机械间歇气泵。多因素logistic回归分析结果显示，采用下肢机械间歇气泵( OR＝0.245，95% CI: 0.132～0.452)是预防VTE发生的保护因素( P<0.05)。 结论:创伤性颅内出血患者的VTE发生率较高，是重要的临床并发症之一。患者年龄≥40岁、经输血治疗更易发生VTE，尽早使用下肢机械间歇气泵预防，可显著减少VTE的发生。

abstractsObjective:To investigate the incidence and related factors of venous thromboembolism (VTE) developed during treatment of traumatic intracranial hemorrhage.Methods:The clinical data of 362 patients with isolated traumatic intracranial hemorrhage (multiple injuries excluded) treated at Department of Neurosurgery, Beijing Tiantan Hospital Affiliated to Capital Medical University from May 2017 to October 2019 were analyzed retrospectively. During hospitalization, patients with clinical high-risk for VTE or those of highly suspected VTE were evaluated by color Doppler ultrasound or chest spiral CT scan, and were divided into no-VTE group and VTE group. The incidence of VTE and related risk and protective factors were investigated by univariate and multivariate logistic regression analysis.Results:Among 362 patients with merely traumatic intracranial hemorrhage, a total of 160 patients developed VTE, with an overall incidence of 44.2%. The result of logistic regression analysis showed that older age (40-59 years, OR=5.316, 95% CI: 2.322-11.173, ≥60 years, OR value=11.221, 95% CI: 4.935-25.518) and blood transfusion treatment after admission ( OR=2.396, 95% CI: 1.413-4.063) were risk factors for VTE (all P<0.05). Inpatients were treated with different measures to prevent possible VTE, which included active/passive activities in 158 cases (43.7%), using lower limb elastic socks in 104 cases (28.7%), and using mechanical intermittent air pump for lower extremities in 100 cases (27.6%). The result of logistic regression analysis showed that using mechanical intermittent air pump for lower extremities ( OR=0.245, 95% CI: 0.132-0.452) was a protective factor for VTE ( P<0.05). Conclusions:Patients with traumatic intracranial hemorrhage have a high incidence of VTE, which is one of the most important complications. Older patients (over 40 years of age) admitted to hospital and those receiving blood transfusions are more likely to develop VTE. Early use of lower limb mechanical air pumps can significantly reduce the incidence of VTE.