骨科大手术围手术期止血及抗凝药物的选择被引量：17

Choice of hemostasis and anticoagulation drugs in perioperative period of orthopaedic major surgery

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摘要骨科大手术包括全膝关节、全髋关节置换及髋部周围骨折所行手术。一方面行骨科大手术的患者术后因静脉血流缓慢、静脉壁损伤和血液高凝状态等原因,往往具有较高的血栓形成风险,易发生下肢深静脉血栓(DVT)或肺栓塞(PE)即静脉血栓栓塞(VTE),严重影响术后的恢复甚至有致死风险,基于此原因,围手术期抗凝不容忽视。另一方面,骨科大手术围手术期出血风险较高,抗凝虽能较好地预防血栓,但同时也增加了骨科大手术围手术期本身存在的出血风险,故抗凝与出血在围手术期须达到一种平衡,以获得最好的抗凝效果及最小的出血风险。 Orthopaedic major surgery includes total knee and hip replacements as well as the surgeries operating on the hip fractures. On one hand,because of the slow vein blood stream,vessel wall damage and high blood coagulation state after the surgery,the patients are with high risks of thrombosis,prone to develop deep vein thrombosis（ DVT） of the lower extremity or pulmonary embolism（ PE） which are called venous thromboembolism（ VTE）,which can have serious impact on the postoperative recovery and even cause death. So the anticoagulation of the perioperative period can not be ignored. On the other hand,orthopaedic major surgery also has high risk of bleeding,anticoagulation,although preventing thrombus,but itself also increasing the risk of hemorrhage. So in order to obtain the best effect of the anticoagulant and minimize the risk of bleeding. the anticoagulant and hemorrhage in perioperative period must reach a balance.

作者于杰曾春蔡道章

机构地区南方医科大学第三附属医院(广东省骨科研究院)关节外科

出处《中华关节外科杂志（电子版）》 CAS 2016年第1期89-92,共4页 Chinese Journal of Joint Surgery(Electronic Edition)

关键词骨科大手术围手术期医护止血抗凝药静脉血栓形成肺栓塞 Orthopaedic major surgery Perioperative care Hemostasis Anticoagulants Venous thrombosis Pulmonary embolism

分类号 R687 [医药卫生—骨科学]

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参考文献30

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