脊柱外科手术后预防静脉血栓栓塞症的共识与争议

Consensus and controversy on prophylaxis of venous thromboembolism after spinal surgery

静脉血栓栓塞症包括深静脉血栓和肺栓塞,是脊柱外科手术后不容忽视的并发症。其预防措施包括基本预防、物理预防、药物预防及下腔静脉滤器置入。但目前并没有系统的预防指南指导临床工作。考虑到药物预防可能增加术后出血性并发症的风险,诸多学者对其使用的必要性及安全性存在争议。本文对目前脊柱术后预防静脉血栓栓塞症存在的共识和争议做一综述,旨在平衡患者的获益与风险,寻找最优方案。

Venous thromboembolism includes deep venous thrombosis and pulmonary thromboembolism,which cannot be ignored after spinal surgery.Prevention of venous thromboembolism includes basic prophylaxis,physical prophylaxis,medical prophylaxis and inferior vena cava filter.However,there is no systematic clinical guideline for prophylaxis.Considering for the potential risk of bleeding complications resulting from medical prophylaxis,scholars have different views on the necessity and safety of using it.This review will give a comprehensive introduction of consensus and controversy,to balance patients'benefits and risks and try to find an optimal method to prevent venous thromboembolism.