Deep venous thrombosis and pulmonary embolism in psychiatric settings
Deep venous thrombosis and pulmonary embolism in psychiatric settings
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精神科环境中的深静脉血栓形成和肺栓塞
DOI：
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发表时间：
2009
期刊：
影响因子：
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通讯作者：
M. Leysen
中科院分区：
文献类型：
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作者：
Els G. Van Neste;W. Verbruggen;M. Leysen
背景和目标：深静脉血栓形成和肺栓塞是严重的、可能危及生命的事件，在精神科环境中经常被忽视。本文调查了哪些精神病患者发生静脉血栓栓塞的风险较高。据我们所知，我们是第一个对静脉血栓形成和肺栓塞与精神药物和精神障碍相关的临床研究进行文献综述的人。方法：使用适当的搜索词在 Medline 上搜索英语研究。此外，还考虑了相关文章文献参考文献的交叉引用。我们保留了 12 项观察性研究、29 项病例报告和一篇评论文章。结果：我们发现证据表明，用于治疗难治性精神分裂症的低效抗精神病药物（如氯丙嗪和硫利达嗪）以及氯氮平会增加静脉血栓栓塞的风险。没有证据表明抗抑郁药、苯二氮卓类药物或情绪稳定剂具有类似的效果。此外，身体束缚、紧张症和抗精神病药恶性综合征等精神疾病也与深静脉血栓形成的较高发生率有关。结论：回顾了有关潜在生物学机制的研究和假设的局限性。讨论了预防措施的基本原理，并给出了预防深静脉血栓和肺栓塞的建议。
Background and objectives: Deep venous thrombosis and pulmonary em- bolism are serious, possibly life-threatening events which are often ignored in psychiatric settings. This article investigates which psychiatric patients are at increased risk of devel- oping a venous thromboembolism. To our knowledge we are the first to perform a litera- ture review of clinical studies relating venous thrombosis and pulmonary embolism to psychotropic drugs and mental disorders. Methods: A Medline search for English studies using the appropriate search terms was performed. In addition, cross references of the relevant articlesliterature references were considered. We withheld 12 observational studies, 29 case-reports and one review-article. Results: We found evidence that low potency antipsychotic drugs like chlorpromazine and thioridazine, and clozapine for treatment of resistant schizophrenia have an increased risk of venous thromboembolism. There is no evidence that antidepressants, benzodi- azepines or mood stabilizers have a similar effect. Also psychiatric conditions like physi- cal restraint, catatonia and neuroleptic malignant syndrome are related to a higher inci- dence of deep venous thrombosis. Conclusions: Limitations of the studies and hypotheses about underlying biological mechanisms are reviewed. The rationale for prophylactic measures is discussed and rec- ommendations to prevent deep venous thrombosis and pulmonary embolism are given.