手術を受けた患者の静脈性血栓栓塞栓症の予防
1Stroke Unit & Division of Cardiovascular Medicine, Department of Internal Medicine, University of Perugia, Italy. agnellig@unipg.it
Circulation
|December 16, 2004
まとめ
静脈血栓塞栓症 (VTE) 予防は,手術患者のために非常に重要です. 抗凝固剤や機械的介入を含む様々な方法は,手術の種類や患者のリスク要因に応じて有効です.
科学分野:
- 医学科学 医学科学 医学科学 医学科学
- 手術による合併症
- トロンボシス研究研究
背景:
- 静脈血栓塞栓症 (VTE) は,外科手術後の頻繁に起こる合併症です.
- VTEのリスクは,患者特有の要因と手術のタイプによって影響を受けます.
- 予防は,外科でのVTEの軽減に不可欠です.
研究 の 目的:
- 手術患者のVTE予防のための現在の戦略をレビューする.
- 手術のリスクとタイプに基づいて推奨される予防措置の概要を述べる.
- 手術後のVTE予防に関するさらなる研究を必要とする分野を特定する.
主な方法:
- 手術におけるVTE予防に関する既存の文献のレビュー.
- 手術によるVTEリスクの分類 (一般的,整形外科,神経外科など).
- 薬理学的介入 (ヘパリン,LMWH,VKA,フォンダパリヌックスなど) と機械的介入 (ストッキング,動員など) の分析.
主要な成果:
- 低用量の未分化ヘパリンまたは低分子量ヘパリン (LMWH) は,一般的,婦人科,血管,主要な泌尿器科手術に推奨されます.
- 低リスクの泌尿器科手術には早期動員が十分であり,高リスクの処置 (股関節置換,股関節骨折) には抗凝固薬 (VKA,LMWH,フォンダパリヌックス) が必要である.
- 徐々に弾性ストッキングは,潜在的にLMWHで,神経外科手術に有効です; 脊椎,腹腔鏡,および関節鏡手術の予防法は,定義が少ないです.
結論:
- 機械的および薬理学的方法を用いた通常のVTE予防は,ほとんどの手術患者のために推奨されます.
- 特定の予防戦略は,手術の種類と個々の患者のリスクに応じて調整する必要があります.
- 症状のない深静脈栓塞のスクリーニング,最適なタイミング,予防治療の持続時間に関するさらなる研究が必要である.
関連する概念動画
Peripheral Artery Disease V: Postoperative Nursing Management
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
Venous Thrombosis I: Introduction
Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
Venous Thrombosis III: Interprofessional Care
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
Venous Thrombosis IV: Nursing Management
Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
Pulmonary Embolism III: Nursing Management
A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...


