关键词: 自发性脑出血, 静脉血栓栓塞症, 危险因素, 预防措施, 分层管理

Abstract: Objective To explore the independent risk factors for venous thromboembolism（VTE）in patients with spontaneous intracerebral hemorrhage（SICH）and to assess the effectiveness and safety of targeted stratified prophylaxis to provide a basis for optimizing prevention and treatment strategies in the clinic．Methods A retrospective analysis was conducted on 86 SICH patients admitted between January 2022 and January 2025．Based on lower-extremity venous ultrasound findings,patients were divided into a deep venous thrombosis（DVT）group（n=16）and a non-DVT group（n=70）．Baseline characteristics,clinical features,and laboratory indicators were collected．Univariate and multivariate Logistic regression analyses were performed to identify VTE risk factors,and a stratified prevention protocol was developed based on independent risk factors．Results Multivariate analysis revealed that elevated body mass index（BMI）（OR=1.22,95%CI：1.06-1.41）,central venous catheterization（OR=5.23,95%CI：1.37-19.95）,hemostatic drug use（OR=4.80,95%CI：1.21-19.01）,and higher NIHSS scores（OR=1.20,95%CI：1.02-1.42）were independent risk factors for VTE（all P<0.05）．Consequently,targeted nursing interventions should be implemented for SICH patients,including BMI-based personalized care,refined management of central venous catheters,dynamic regulation of hemostatic drugs,and neuroprotective early rehabilitation．Conclusions VTE in SICH patients is closely associated with the interplay of metabolic,iatrogenic,and neurological injury factors．A stratified prevention strategy incorporating BMI monitoring,central venous catheter management,and coagulation surveillance is critical for reducing thrombotic risk while ensuring safety．

Key words: spontaneous intracerebral hemorrhage, venous thromboembolism, risk factors, preventive measures, stratified management