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)

作　　者：周武[1] 曹发奇 曾睿寅 姜保国[2] 唐佩福[3] 吴新宝[4] 余斌[5] 侯志勇[6] 黎健 苏佳灿 刘国栋 禹宝庆 袁志 倪江东[12] 陈雁西 傅德皓 童培建[15] 王栋梁[16] 张殿英[2] 张鹏[17] 张云飞 牛丰[19] 杨雷[20] 杨强[21] 施忠民[22] 周强 王俊文[24] 王勇 何承建 车彪 赵猛[28] 夏平[29] 熊蠡茗 曹烈虎 陈晓 李卉 孙云 胡良聪 胡衍 刘梦非 米博斌 熊元[1] 薛航 林泽 张英泽[6] 胡豫[1] 刘国辉[1] Zhou Wu;Cao Faqi;Zeng Ruiyin;Jiang Baoguo;Tang Peifu;Wu Xinbao;Yu Bin;Hou Zhiyong;Li Jian;Su Jiacan;Liu Guodong;Yu Baoqing;Yuan Zhi;Ni Jiangdong;Chen Yanxi;Fu Dehao;Tong Peijian;Wang Dongliang;Zhang Dianying;Zhang Peng;Zhang Yunfei;Niu Feng;Yang Lei;Yang Qiang;Shi Zhongmin;Zhou Qiang;Wang Junwen;Wang Yong;He Chengjian;Che Biao;Zhao Meng;Xia Ping;Xiong Liming;Cao Liehu;Chen Xiao;Li Hui;Sun Yun;Hu Liangcong;Hu Yan;Liu Mengfei;Mi Bobin;Xiong Yuan;Xue Hang;Lin Ze;Zhang Yingze;Hu Yu;Liu Guohui(Union Hospital of Tongji Medical University Affiliated to Huazhong University of Science and Technology,Wuhan 430022,China;People′s Hospital of Peking University,Beijing 100044,China;Chinese PLA General Hospital,Beijing 100853,China;Beijing Jishuitan Hospital,Beijing 100035,China;Nanfang Hospital,Nanfang Medical University,Guangzhou 510515,China;Third Hospital of Hebei Medical University,Shijiazhuang 050051,China;Beijing Institute of Geriatrics,Natronal Health Commission,Beijing 100730,China;First Affiliated Hospital of Naval Medical University,Shanghai 200433,China;Daping Hospital,Army Medical University,Chongqing 400042,China;Pudong Hospital Affiliated to Fudan University,Shanghai 201399,China;Xijing Hospital,Air Force Medical University,Xi′an 710032,China;Second Xiangya Hospital of Central South University,Changsha 410011,China;Zhongshan Hospital Affiliated to Fudan University,Shanghai 200032,China;First People′s Hospital Affiliated to Shanghai Jiao Tong University,Shanghai 200080,China;Zhejiang Provincial Hospital of Chinese Medicine,Hangzhou 310003,China;Xinhua Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China;Shandong Provincial Hospital,Jinan 250021,China;Tangdu Hospital Affiliated to Air Force Military Medical University,Xi′an 710038,China;First Hospital of Bethune Affiliated to Jilin University,Changchun 130021,China;Second Affiliated Hospital of Wenzhou Medical University,Wenzhou 325027,China;Tianjin Hospital,Tianjin 300211,China;Sixth People′s Hospital Affiliated to Shanghai Jia

机构地区：[1]华中科技大学同济医学院附属协和医院,武汉430022 [2]北京大学人民医院,北京100044 [3]中国人民解放军总医院,北京100853 [4]北京积水潭医院,北京100035 [5]南方医科大学南方医院,广州510515 [6]河北医科大学第三医院,石家庄050051 [7]国家卫健委北京老年医学研究所,北京100730 [8]海军军医大学第一附属医院,上海200433 [9]陆军军医大学大坪医院,重庆4000042 [10]复旦大学附属浦东医院,上海201399 [11]空军军医大学西京医院,西安710032 [12]中南大学湘雅二医院,长沙410011 [13]复旦大学附属中山医院,上海200032 [14]上海交通大学附属第一人民医院,上海200080 [15]浙江省中医院,杭州310003 [16]上海交通大学附属新华医院,上海200092 [17]山东省立医院,济南250021 [18]空军军医大学唐都医院,西安710038 [19]吉林大学白求恩第一医院,长春130021 [20]温州医科大学附属第二医院,温州325027 [21]天津市天津医院,天津300211 [22]上海交通大学附属第六人民医院,上海200233 [23]重庆医科大附属第三医院,重庆401120 [24]武汉市第四医院,武汉430030 [25]温州市中西医结合医院,温州325003 [26]湖北中医药大学附属医院,武汉430060 [27]长江航运总医院,武汉430019 [28]十堰市太和医院,十堰442099 [29]武汉市第一医院,武汉430022

出　　处：《中华创伤杂志》2022年第1期23-31,共9页Chinese Journal of Trauma

基　　金：国家重点研发计划(2018YFC2001500)。

摘　　要：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.

关 键 词：创伤骨科患者 并发肺栓塞 循证医学证据 下肢静脉血栓形成 血栓脱落 下肢骨折患者 供血不足 动脉供血 

分 类 号：R543.6[医药卫生—心血管疾病] R687.3[医药卫生—内科学]