普外科围手术期抗栓治疗管理进展

Advances in perioperative antithrombotic therapy for general surgery

目的总结普外科围手术期静脉血栓栓塞症(venous thromboembolism,VTE)发生发展的概况,同时总结围手术期的抗栓治疗策略。方法收集国内外有关抗栓治疗的文献及指南并作综述。结果围手术期VTE很常见。在围手术期合理评估每例患者的情况,采用合理的预防措施,同时规范地使用抗凝、抗血小板药物及止血剂可以减少围手术期VTE事件的发生。结论如何平衡好血栓栓塞与出血之间的平衡是一个富有争议的话题,需要我们学习并加以掌握,制定合理的抗栓策略,降低栓塞并发症,从而更好地为患者服务。

Objective To summarize the general situation of perioperative venous thromboembolism （VTE） and summarize the perioperative antithrombotic strategies. Methods Domestic and international literatures and guidelines on antithrombotic therapy were collect and reviewed. Results VTE was common during the perioperative period. Reasonable assessment of each patient＇s condition during the perioperative period, as well as reasonable use of anticoagulant, antiplatelet drugs, and hemostatic agents could reduce the incidence of VTE events during the perioperative period. Conclusions Clinicians need to properly assess the timing of the usage and discontinuation of antithrombotic drugs, weigh the risk of thrombosis and bleeding, develop a rational and scientific antithrombotic strategy based on the specific circumstances of each patient. Simultaneously, hemostatic agents need to be prescribed perioperatively to reduce the incidence of thromboembolic complications.