老年患者凝血功能变化及骨科手术凝血相关并发症  

Changes of coagulation function in elderly patients and related complications of orthopedic surgery

作　　者：乔昌龙 张晓宁[1] 房廷豪 吕连超 王月兰[1] Qiao Changlong;Zhang Xiaoning;Fang Tinghao;Lyu Lianchao;Wang Yuelan(Department of Anesthesiology and Perioperative Medicine,the First Affiliated Hospital of Shandong First Medical University(Shandong Provincial Qianfoshan Hospital),Jinan 250014,China)

机构地区：[1]山东第一医科大学第一附属医院(山东省千佛山医院)麻醉与围术期医学科,济南250014

出　　处：《国际麻醉学与复苏杂志》2022年第3期288-293,共6页International Journal of Anesthesiology and Resuscitation

摘　　要：老年患者身体机能退化,自我修复能力逐渐降低,围手术期并发症尤其是与凝血功能、脑卒中相关的并发症发生率较高。文章综述了老年患者凝血功能特点,骨科手术围手术期术中损伤、酸中毒、低体温、输血、体位等对凝血机制影响,预防骨科手术深静脉血栓形成的措施,老年患者骨折与脑卒中的关系,骨科手术预防血栓与麻醉之间的关系。提示临床医师在使用抗凝药进行血栓预防时应充分权衡血栓预防带来的获益与出血风险之间的利弊关系,选择合适的抗凝方案,最大程度地降低血栓性疾病与出血等相关事件的发生,以期减少此类疾患围手术期并发症和不良事件。Due to the degradation of physical function and the gradual decrease of self‑repair ability in elderly patients,the in‑cidences of perioperative complications,especially those related to coagulation function and stroke are still very high.This paper re‑views the characteristics of coagulation in elderly patients,the effects of perioperative injury,acidosis,hypothermia,blood transfusion and posture on blood coagulation mechanism in orthopedic surgery,and the measures to prevent deep venous thrombosis in orthopedic surgery,the relationship between fracture and stroke in elderly patients and the relationship between thrombus prevention and anesthe‑sia in orthopedic surgery.It is suggested that during when thrombotic prevention with anticoagulants,clinical doctors should fully weigh the advantages and disadvantages of thrombotic prevention and the risk of bleeding,and choose appropriate anticoagulant regimens to minimize the occurrence of thrombotic diseases,bleeding and other related events,so as to reduce the perioperative complications and adverse events caused by such diseases.

关 键 词：凝血 骨科手术 围手术期 并发症 静脉血栓形成 麻醉 

分 类 号：R614[医药卫生—麻醉学]