外科住院病人并发下肢深静脉血栓高危因素及诊治进展  

Risk factors and progress in diagnosis and treatment of surgical inpatients complicated with lower extremity deep vein thrombosis

作　　者：郭文城 余波 史伟浩 GUO Wen-cheng;YU Bo;SHI Wei-hao(Department of Vascular Surgery,Huashan Hospital Affiliated to Fudan University,Shanghai 200040,China)

机构地区：[1]复旦大学附属华山医院血管外科,上海200040 [2]复旦大学附属浦东医院血管外科,上海201399

出　　处：《中国实用外科杂志》2020年第5期594-598,共5页Chinese Journal of Practical Surgery

基　　金：上海市自然科学基金(No.18ZR1433900);上海市浦东新区卫生系统重点学科群建设资助(No.PWZ-xq2017-09);上海市医学重点专科(No.ZK2019A10)。

摘　　要：外科住院病人需联合Caprini评分,多因素综合评判下肢深静脉血栓形成(LEDVT)的高危因素,指导预防围手术期LEDVT。围手术期LEDVT及时诊断依赖于反复动态的观察、评估。抗凝治疗仍是首选基本治疗,但需重视出血风险评估。腔静脉滤器应严格把握适应证并重视回收率。经导管接触性溶栓对于预防下肢深静脉血栓后综合征有明确意义,但会增加各类出血风险。各类经皮血栓机械清除术仍待进一步研究以明确其临床应用价值。Surgical inpatients should be combined with caprini score to comprehensively evaluate the high risk factors of lower extremity deep vein thrombosis(LEDVT)and guide the prevention of perioperative LEDVT.The timely diagnosis of LEDVT in perioperative period depends on repeated dynamic observation and evaluation.Anticoagulant therapy is still the first choice of basic treatment,but clinicians need to pay attention to the risk assessment of bleeding.The indication of vena cava filter should be strictly controlled and the recovery rate should be paid attention to.Catheter directed thrombolysis is of great significance in the prevention of postthrombosis syndrome,but it will increase the risk of bleeding.All kinds of percutaneous mechanic thrombectomy still need further study to clarify its clinical application value.

关 键 词：围手术期 下肢深静脉血栓形成 高危因素 腔静脉滤器 经皮血栓机械清除术 

分 类 号：R6[医药卫生—外科学]