OBJECTIVE To evaluate the results of thromboembolic prophylaxis using enoxaparin in acute spinal injury patients. BACKGROUND Deep vein thrombosis and pulmonary embolism are major causes of morbidity and mortality in patients with acute spinal injuries. A wide range of thromboprophylactic measures have been proposed. The present study describes the outcome of a regime of enoxaparin and antithromboembolic stockings in acute spinal injuries irrespective of neurological damage. SETTING Scotland, UK. METHODS Eighteen-month retrospective review of acute spinal injury patients admitted to a national spinal injuries unit. A thromboembolic prophylactic regimen of early mobilisation, use of antithromboembolic stockings, and subcutaneous administration of enoxaparin 40 mg once a day until patients could be mobilised for more than 4 h per day, was used. Patients with clinical suspicion of deep venous thrombosis or pulmonary embolism were investigated as appropriate. RESULTS Out of 146 (53% of total) patients with spinal injuries with no neurological deficit only one patient (0.4%) developed clinical evidence of pulmonary embolism and out of 130 (47% of total) with spinal cord injury two (0.7%) developed clinical evidence of deep venous thrombosis while still on enoxaparin. Four patients (1.5%) developed deep venous thrombosis and one (0.4%) pulmonary embolism after discontinuing enoxaparin. There were no fatal pulmonary emboli and one suspected intraspinal bleeding. CONCLUSIONS The present study suggests that, in addition to physical and mechanical measures, low molecular weight heparin in the form of enoxaparin 40 mg administered once daily compares favourably with previous studies for thromboprophylaxis in acute spinal injuries.

中文翻译：

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预防脊髓损伤中的血栓栓塞-276例患者使用了依诺肝素。

目的评估依诺肝素在急性脊髓损伤患者中预防血栓栓塞的结果。背景技术深静脉血栓形成和肺栓塞是急性脊髓损伤患者发病和死亡的主要原因。已经提出了多种血栓预防措施。本研究描述了依诺肝素和抗血栓栓塞长袜在急性脊髓损伤中的治疗方案，无论神经损伤如何。地点英国，苏格兰。方法对入选国家脊柱损伤科的急性脊柱损伤患者进行18个月的回顾性研究。使用了早期动员的血栓栓塞预防方案，使用抗血栓栓塞的长袜以及每天一次皮下注射依诺肝素40 mg，直到每天可以动员超过4小时为止。临床怀疑深静脉血栓形成或肺栓塞的患者进行了适当的调查。结果146例（占总数的53％）无神经功能缺损的脊髓损伤患者中，只有一名患者（0.4％）表现出肺栓塞的临床证据，而130例（占总数的47％）患有脊髓损伤，有2例（占0.7％）在仍使用依诺肝素的同时，已开发出深静脉血栓形成的临床证据。停用依诺肝素后有4名患者（1.5％）发生深静脉血栓形成和1名（0.4％）肺栓塞。没有致命的肺栓塞和1例可疑的椎管内出血。结论本研究表明，除了物理和机械措施外，