Davis J D
Division of Gynecology, University of Florida College of Medicine, Gainesville, FL 32610-0294, USA.
Am J Obstet Gynecol. 2001 Mar;184(4):759-75. doi: 10.1067/mob.2001.110957.
Deep vein thrombosis and pulmonary embolism, collectively referred to as venous thromboembolic events, are a source of significant morbidity and mortality after gynecologic surgical procedures. In this literature review the advantages and disadvantages of various preventive measures for deep venous thrombosis, including low-molecular-weight heparins, are discussed. The most appropriate prophylactic methods for patients in varying risk categories are recommended. Current methods of diagnosing deep venous thrombosis and pulmonary embolism, including ultrasonography, venography, ventilation-perfusion scan, helical computed tomographic scan, and D -dimer measurement are then discussed. Finally, treatment modalities for deep venous thrombosis and pulmonary embolism, including heparin, low-molecular-weight heparin, warfarin, and thrombolytic therapy, are detailed.
深静脉血栓形成和肺栓塞统称为静脉血栓栓塞事件,是妇科手术后严重发病和死亡的一个原因。在这篇文献综述中,讨论了包括低分子肝素在内的各种深静脉血栓形成预防措施的优缺点。推荐了针对不同风险类别的患者最适宜的预防方法。接着讨论了目前诊断深静脉血栓形成和肺栓塞的方法,包括超声检查、静脉造影、通气灌注扫描、螺旋计算机断层扫描和D -二聚体检测。最后,详细介绍了深静脉血栓形成和肺栓塞的治疗方式,包括肝素、低分子肝素、华法林和溶栓治疗。