Rehabilitation Combined with Coagulation Tests for the Prevention of DVT in Patients After Hypertensive Intracerebral Hemorrhage Surgery.

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.