创伤骨科患者围术期下肢静脉血栓形成诊断及防治专家共识(2022年)

Expert consensus on diagnosis,prevention and treatment of perioperative lower extremity vein thrombosis in orthopedic trauma patients(2022 edition)

下肢深静脉血栓形成(DVT)是创伤骨科患者的主要并发症之一,严重DVT甚至会影响动脉供血,出现相应肢体供血不足。若发生血栓脱落可并发肺栓塞,病死率较高。临床上下肢骨折患者DVT的治疗和康复策略均有其特殊性。创伤骨科患者并发DVT已经引起广泛的关注与研究,预防和治疗DVT的最佳措施也在不断发展。近年来国内外陆续更新了一系列血栓防治指南,但临床上对于不同创伤骨折患者DVT的防治方式仍有不少疑惑。因此,笔者在总结国内外最新的循证医学证据和广大专家的临床经验基础上,针对创伤骨科患者DVT的临床诊疗和预防方案进行总结,就下肢DVT的诊断、评估、治疗及预防措施等方面制订本共识,为创伤骨科患者下肢DVT的处理提供一套适合我国国情且简便易行的方案,以期改善患者预后,提高其生活质量。

Lower extremity deep vein thrombosis(DVT)is one of the main complications in patients with traumatic fractures,and for severe patients,the DVT can even affect arterial blood supply,resulting in insufficient limb blood supply.If the thrombus breaks off,pulmonary embolism may occur,with a high mortality.The treatment and rehabilitation strategies of thrombosis in patients with lower extremity fractures have its particularity.DVT in traumatic fractures patients has attracted extensive attention and been largely studied,and the measures for prevention and treatment of DVT are constantly developing.In recent years,a series of thrombosis prevention and treatment guidelines have been updated at home and abroad,but there are still many doubts about the prevention and treatment of DVT in patients with different traumatic fractures.Accordingly,on the basis of summarizing the latest evidence-based medical evidence at home and abroad and the clinical experience of the majority of experts,the authors summarize the clinical treatment and prevention protocols for DVT in patients with traumatic fractures,and make this consensus on the examination and assessment,treatment,prevention and preventive measures for DVT in patients with different fractures so as to provide a practicable approach suitable for China′s national conditions and improve the prognosis and the life quality of patients.