摘要
静脉的 thromboembolism (VTE ) 作为深静脉血栓(DVT ) 和肺的栓塞(PE ) 被表明，代表死亡，残疾，和不快的一个重要原因。他们是各种各样的外科的过程的经常的复杂并发症。变老的人口和更严重地受伤的病人的幸存可以在损伤病人建议 thromboembolism 的增加的风险。在风险挑战医生扩展了人口的理解小心地检验风险因素让 VTE 识别能得益于预防的高风险的病人。基于证据的风险因素的精确知识在预言并且阻止手术后的 DVT 是重要的，并且能为 appropriatethromboprophylaxis 使用被合并到一个决定支持系统。在一张高风险的损伤人口的 DVT 预防的标准使用在下导致 DVT 的发生。VTE 的发生在亚洲是普通的。评估包括实验室测试， Doppler 测试和 phlebography。屏蔽 Doppler sonography 应该在所有非常受伤的病人上为监视被执行识别 DVT。D 暗淡是一个有用标记在损伤外科病人监视预防。开始预防的最佳的调子以前在 2hours 之间并且在外科以后的 10 个小时，而是 PE 的风险继续因为几 weeks.Thromboprophylaxis 为预防包括毕业压缩袜子和抗凝剂。抗凝剂包括 Warfarin，它属于维生素 K 对手， unfractionatedheparin，低分子的重量肝磷脂，因素 Xa 间接禁止者 Fondaparinux，和口头的 IIainhibitor Melagatran 和 ximelagatran。Recombinant 人的 solublethrombomodulin 是一个新、高度有效的 antithrombotic 代理人。在选择损伤病人的 venacaval 过滤器的预防放置可以减少 PE 的发生。为预防劣等的静脉 cava 过滤器插入的指示与多重损害，关上的头损害，骨盆的破裂，脊骨破裂，多重长骨头破裂，和出席谨慎包括延长固定。多重损伤的病人在为 DVT 的增加的风险，但是也在流血，和肝磷脂的使用的增加的风险可以被禁忌。连续压缩设备(SCD ) 是为 DVT 预防的一种选择。压缩设备向足够的 DVTprophylaxis 提供低失败率和没有设备相关的复杂并发症。固定是 VTE 的重要原因之一。走动的病人多半少些是远的发展迟钝，不是仅仅静脉的血栓的复杂并发症，而且挛缩，褥疮溃疡，或骨质疏松症(与它的联系疲劳破裂) ，以及肠或膀胱复杂并发症。
Venous thromboembolism （ VTE）, which is manifested as deep vein thrombosis （ DVT ） and pulmonary embolism （PE）, represents a significant cause of death, disability, and discomfort. They are frequent complications of various surgical procedures. The aging population and the survival of more severely injured patients may suggest an increasing risk of thromboembolism in the trauma patients. Expanded understanding of the population at risk challenges physicians to carefully examine risk factors for VTE to identify high-risk patients who can benefit from prophylaxis. An accurate knowledge of evidence-based risk factors is important in predicting and preventing postoperative DVT, and can be incorporated into a decision support system for appropriate thromboprophylaxis use. Standard use of DVT prophylaxis in a high-risk trauma population leads to a low incidence of DVT. The incidence of VTE is common in Asia. The evaluation includes laboratory tests, Doppler test and phlebography. Screening Doppler sonography should be performed for surveillance on all critically injured patients to identify DVT. D-Dimer is a useful marker to monitor prophylaxis in trauma surgery patients. The optimal time to start prophylaxis is between 2 hours before and 10 hours after surgery, but the risk of PE continues for several weeks. Thromboprophylaxis includes graduated compression stockings and anticoagulants for prophylaxis. Anticoagulants include Warfarin, which belongs to Vitamin K antagonists, unfractionated heparin, low molecular weight heparins, factor Xa indirect inhibitor Fondaparinux, and the oral Ha inhibitor Melagatran and ximelagatran. Recombinant human soluble thrombomodunn is a new and highly effective antithrombotic agent. Prophylactic placement of vena caval filters in selected trauma patients may decrease the incidence of PE. The indications for prophylactic inferior vena cava filter insertion include prolonged immobilization with multiple injuries, closed head injury, pelvic fracture, spine fracture, multiple long bone fracture, and attending discretion. Multlple-trauma patients are at increased risk for DVT but are also at increased risk of bleeding, and the use of heparin may be contraindicated. Serial compression devices （SCDs） are an alternative for DVT prophylaxis. Compression devices provide adequate DArT prophylaxis with a low failure rate and no device-related complications. Immobilization is one of important reasons of VTE. The ambulant patient is far less likely to develop complications of inactivity, not only venous thrombosis, but also contractures, decubitns ulcers, or osteoporosis （with its associated fatigue fractures）, as well as bowel or bladder complications.
