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陈勇.围手术期静脉血栓栓塞症的风险评估及预防[J].内科急危重症杂志,2025,31(5):409-414
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| DOI：10.11768/nkjwzzzz20250504 |
| 中文关键词: 静脉血栓栓塞症 围手术期 肺血栓栓塞症 |
| 英文关键词: |
| 基金项目:十四五“国家重点研发计划”(2023YFC2507203)；重庆市卫生健康委员会名家名师（医学领域）项目(CQYC20220203178) |
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| 摘要点击次数: 17 |
| 全文下载次数: 17 |
| 中文摘要: |
| 摘要 静脉血栓栓塞症（VTE）是可预防的主要术后并发症，目前围手术期VTE总体预防率低。对所有手术患者都应该进行VTE风险评估，并对VTE风险评估为中高风险的患者进行出血风险评估。VTE风险评估可以根据患者和手术的特定因素，使用经过验证的风险评估模型（如Caprini评分）进行评估。目前还没有经过验证的模型来预测围手术期出血，但已经提出了出血风险因素。针对 VTE不同风险以及出血的风险，平衡血栓与出血的情况制定血栓预防方案。VTE预防措施通常应持续使用直到患者可以走动或出院；接受腹盆腔恶性肿瘤手术和某些骨科手术的高危患者等情况下可以考虑延长VTE的预防时间。 |
| 英文摘要: |
| Abstract Venous thromboembolism (VTE) is a major preventable postoperative complication, and the overall prevention rate of VTE during the perioperative period is currently low. VTE risk assessment should be conducted for all surgical patients, and bleeding risk assessment should be conducted for patients with moderate to high VTE risk assessment. VTE risk assessment can be conducted using validated risk assessment models (such as Caprini score) based on specific factors of the patient and surgery. There is currently no validated model to predict perioperative bleeding, but bleeding risk factors have been identified. It is necessary to develop a thrombosis prevention plan that balances thrombosis and bleeding based on the different risks of VTE and bleeding. VTE prevention measures should usually be continued until the patient can walk or be discharged; In high-risk patients undergoing surgery for malignant abdominopelvic operations and certain orthopedic operations, it may be considered to extend the prevention time of VTE. |
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