骨科手术静脉血栓栓塞症的预防进展

Progress in prevention of venous thromboembolism in orthopaedic surgery

骨科手术后患者常需要长时间保持卧床静养,易导致一系列并发症,其中较为常见且典型的即静脉血栓栓塞症。据以往资料统计,骨科手术后未进行有效血栓预防工作的3个月内患者静脉血栓栓塞症发生概率高达40%~60%,尤其是近几年来,随着我国骨科外科领域的发展,手术复杂性及困难性不断增加,手术创伤较大,导致术后静脉血栓栓塞风险随之增加。一旦出现该并发症,就必须给予快速且有效的治疗,例如肝素类药物、维生素K拮抗剂等,否则可能导致严重的后遗症甚至肺栓塞,降低治疗效果,危及患者生命安全。因此,针对骨科手术患者,提前做好静脉血栓栓塞症的防治工作十分必要。目前,临床上关于预防静脉血栓栓塞症的方法复杂多样,例如机械性预防、西药或中药预防等,采取哪种措施能够更加有效降低静脉血栓栓塞症的发生尚未形成统一定论。基于此,本文就骨科术后静脉血栓栓塞症相关预防措施开展综述,以期为骨科手术静脉血栓栓塞症的预防提供参考。

Patients after orthopaedic surgery often need to stay in bed and rest for a long time,which is likely to lead to a series of complications.Among them,the more common and typical is venous thromboembolism.According to previous data statistics,the incidence of venous thromboembolism in patients without effective thrombosis prevention work within 3 months after orthopaedic surgery is as high as 40%-60%,especially in recent years,with the rapid development of orthopaedic surgery in China,the complexity and difficulty of surgery are increasing,and the surgical trauma is large,which lead to the increased risk of postoperative venous thromboembolism.Once this complication occurs,it must be treated quickly and effectively,such as heparin drugs and vitamin K antagonists and so on,otherwise it may lead to serious sequelae or even pulmonary embolism,reduce the treatment effect and endanger the life safety of patients.Therefore,it is necessary to carry out the prevention and treatment of venous thromboembolism in advance for patients undergoing orthopaedic surgery.At present,the clinical methods for the prevention of venous thromboembolism are complex and diverse,such as mechanical prevention,Western medicine or traditional Chinese medicine prevention,etc.What measures can be taken to reduce the occurrence of venous thromboembolism more effectively has not yet formed a unified conclusion.Based on this,this paper reviews the related preventive measures of venous thromboembolism after orthopedic surgery,in order to provide the reference for the prevention of venous thromboembolism.