关于骨科创伤外科手术中的静脉血栓栓塞的最新情况
Jonathan H Wills1, Greg E Gaski
1From the Department of Orthopedic Surgery, Medstar Georgetown University Hospital, Washington D.C., (Wills), and the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Falls Church, VA (Wills and Gaski).
概括
阿司匹林显示非劣质的低分子量肝素预防静脉血栓栓塞 (VTE) 在骨科创伤患者. 直接口服抗凝剂提供更安全的替代品,但最佳预防持续时间尚不清楚.
科学领域:
- 整形外科手术 整形外科手术
- 血管医学是一种血管医学.
- 创伤护理的护理人员.
背景情况:
- 静脉血栓塞栓症 (VTE) 显著增加了骨科创伤患者的发病率和死亡率.
- 目前的指导方针往往有利于低分子量肝素 (LMWH) 用于VTE化学预防.
- 新出现的证据挑战了现有的预防建议.
研究的目的:
- 审查当前的VTE预防策略在骨科创伤.
- 评估最近关于阿司匹林和直接口服抗凝剂 (DOACs) 预防VTE的证据.
- 确定关于最佳预防持续时间和风险分层的知识差距.
主要方法:
- 审查目前的VTE预防指南和最近的高级别证据.
- 对阿司匹林,LMWH和DOACs相对有效性的分析.
- 讨论机械预防和新的预测标记.
主要成果:
- 阿司匹林在预防严重的VTE并发症方面证明与LMWH无劣.
- 直接口服抗凝剂是注射抗凝剂的安全,符合患者需求的替代品.
- 关于创伤后静脉瘤化学预防的最佳门诊持续时间,没有达成共识.
结论:
- 阿司匹林是一种可行的替代LMWH在骨科创伤中进行VTE预防的替代品.
- DOAC 提供了更好的合规性和安全性.
- 需要进一步的研究来确定最佳的预防持续时间,并使用新生物标志物识别高风险患者.
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