在手术患者中预防静脉血栓塞栓症
1Stroke Unit & Division of Cardiovascular Medicine, Department of Internal Medicine, University of Perugia, Italy. agnellig@unipg.it
Circulation
|December 16, 2004
概括
静脉血栓塞栓症 (VTE) 预防对于手术患者至关重要. 根据手术类型和患者的风险因素,包括抗凝剂和机械干预等各种方法是有效的.
科学领域:
- 医学科学 医学科学 医学科学
- 手术并发症 手术并发症
- 血栓形成的研究研究
背景情况:
- 静脉血栓栓塞 (VTE) 是手术后的常见并发症.
- 静脉瘤风险受患者特异性因素和手术类型的影响.
- 预防对于在手术环境中减轻静脉瘤的危害至关重要.
研究的目的:
- 对手术患者的静脉瘤预防目前的策略进行审查.
- 根据手术风险和类型概述推的预防措施.
- 确定需要在手术后进行更多VTE预防研究的领域.
主要方法:
- 对手术中VTE预防现有文献的综述.
- 基于手术程序 (例如,一般,骨科,神经外科手术) 的VTE风险的分类.
- 对药理学 (例如,肝素,LMWH,VKAs, fondaparinux) 和机械 (例如,子,动员) 干预措施的分析.
主要成果:
- 低剂量未分离的氨酸或低分子量氨酸 (LMWH) 建议用于一般性,妇科,血管和主要泌尿外科手术.
- 早期动员足以进行低风险的泌尿外科手术;高风险的手术 (部/膝盖置换,部骨折) 需要抗凝剂 (VKA,LMWH, fondaparinux).
- 渐变弹性,可能有LMWH,在神经外科手术中是有效的;预防在脊柱,腹腔镜和关节镜手术中定义较少.
结论:
- 建议大多数手术患者使用机械和药理方法进行常规静脉瘤预防.
- 具体的预防策略应根据手术类型和个体患者的风险量身定制.
- 需要进一步研究对无症状深静脉血栓的查,最佳时间和预防的持续时间.
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