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已发表论文
高血压脑出血术后患者预防深静脉血栓形成的康复联合凝血功能检测
Received 9 September 2025
Accepted for publication 29 November 2025
Published 19 December 2025 Volume 2025:21 Pages 1761—1771
DOI https://doi.org/10.2147/TCRM.S566486
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Sandeep Ajoy Saha
Lingwen Kong,1 Shan Yao2
1Neurosurgical Intensive Care Unit, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China; 2Department of Rehabilitation, Xuzhou Central Hospital, Southeast University, Xuzhou, Jiangsu, People’s Republic of China
Correspondence: Shan Yao, Department of Rehabilitation, Xuzhou Central Hospital, Southeast University, Room 603, Unit 4, Building 4, Qingnian Community, Yunlong District, Xuzhou, Jiangsu, 221000, People’s Republic of China, Tel +86-15862186026, Email konglingww147@163.com
Objective: To evaluate the efficacy of ultra-early rehabilitation combined with coagulation monitoring in preventing deep vein thrombosis (DVT) in patients following surgical intervention for hypertensive intracerebral hemorrhage (HICH).
Methods: A retrospective cohort study was conducted involving 126 HICH patients treated at the Neurosurgery ICU of The Affiliated Hospital of Xuzhou Medical University and the Rehabilitation Department of Xuzhou Central Hospital between January 2023 and December 2024. Participants were stratified into an experimental group (ultra-early rehabilitation with daily coagulation testing, n=63) and a control group (conventional care, n=63) based on the management protocol they received during their hospitalization. Hemodynamic parameters, muscle strength, and coagulation markers were assessed at baseline (T0: pre-intervention), T1 (postoperative day 1), T7 (postoperative day 7), and T14 (postoperative day 14).
Results: Baseline characteristics demonstrated comparability between groups (P> 0.05). The experimental group exhibited superior muscle strength recovery in both upper and lower extremities, with statistically significant differences emerging at T14 (P< 0.05). Coagulation parameters including fibrinogen (FIB), fibrinogen degradation products (FDP), D-dimer, thrombin-antithrombin III complex (TAT), plasmin-antiplasmin complex (PIC), and thrombomodulin (TM) demonstrated progressive decline in the experimental cohort. At T7, FIB, FDP, and D-dimer levels were significantly lower in the experimental group compared to controls (P< 0.05), with more pronounced reductions observed at T14. TAT, PIC, and TM similarly demonstrated substantial decreases at T14 (P< 0.01). DVT incidence was significantly reduced in the experimental group (12.70% vs 31.75%, P< 0.05).
Conclusion: Ultra-early rehabilitation guided by systematic coagulation monitoring appears to be associated with favorable modulation of hemostatic markers (FIB, FDP, D-dimer, TAT, PIC, TM) and enhanced muscle strength recovery following HICH surgery. This integrated approach may effectively reduce postoperative DVT incidence, offering a promising strategy for thromboprophylaxis management.
Keywords: early ambulation, blood coagulation tests, hypertension, cerebral hemorrhage, postoperative complications, venous thrombosis
1Neurosurgical Intensive Care Unit, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China; 2Department of Rehabilitation, Xuzhou Central Hospital, Southeast University, Xuzhou, Jiangsu, People’s Republic of China
Correspondence: Shan Yao, Department of Rehabilitation, Xuzhou Central Hospital, Southeast University, Room 603, Unit 4, Building 4, Qingnian Community, Yunlong District, Xuzhou, Jiangsu, 221000, People’s Republic of China, Tel +86-15862186026, Email konglingww147@163.com
Objective: To evaluate the efficacy of ultra-early rehabilitation combined with coagulation monitoring in preventing deep vein thrombosis (DVT) in patients following surgical intervention for hypertensive intracerebral hemorrhage (HICH).
Methods: A retrospective cohort study was conducted involving 126 HICH patients treated at the Neurosurgery ICU of The Affiliated Hospital of Xuzhou Medical University and the Rehabilitation Department of Xuzhou Central Hospital between January 2023 and December 2024. Participants were stratified into an experimental group (ultra-early rehabilitation with daily coagulation testing, n=63) and a control group (conventional care, n=63) based on the management protocol they received during their hospitalization. Hemodynamic parameters, muscle strength, and coagulation markers were assessed at baseline (T0: pre-intervention), T1 (postoperative day 1), T7 (postoperative day 7), and T14 (postoperative day 14).
Results: Baseline characteristics demonstrated comparability between groups (P> 0.05). The experimental group exhibited superior muscle strength recovery in both upper and lower extremities, with statistically significant differences emerging at T14 (P< 0.05). Coagulation parameters including fibrinogen (FIB), fibrinogen degradation products (FDP), D-dimer, thrombin-antithrombin III complex (TAT), plasmin-antiplasmin complex (PIC), and thrombomodulin (TM) demonstrated progressive decline in the experimental cohort. At T7, FIB, FDP, and D-dimer levels were significantly lower in the experimental group compared to controls (P< 0.05), with more pronounced reductions observed at T14. TAT, PIC, and TM similarly demonstrated substantial decreases at T14 (P< 0.01). DVT incidence was significantly reduced in the experimental group (12.70% vs 31.75%, P< 0.05).
Conclusion: Ultra-early rehabilitation guided by systematic coagulation monitoring appears to be associated with favorable modulation of hemostatic markers (FIB, FDP, D-dimer, TAT, PIC, TM) and enhanced muscle strength recovery following HICH surgery. This integrated approach may effectively reduce postoperative DVT incidence, offering a promising strategy for thromboprophylaxis management.
Keywords: early ambulation, blood coagulation tests, hypertension, cerebral hemorrhage, postoperative complications, venous thrombosis