Tapson V F
Division of Pulmonary and Critical Medicine, Duke University Medical Center, Durham, North Carolina, USA.
Am J Manag Care. 2001 Nov;7(17 Suppl):S524-31; discussion S531-4.
Pulmonary embolism is one of the most common causes of unexpected death in hospitalized patients and one of the top diseases leading to medical malpractice lawsuits. In order to effectively prevent venous thromboembolism (VTE), physicians must assess patients' risk factors and stratify their risk accordingly. Studies show general medical patients are most likely to suffer from deep vein thrombosis. Research also indicates that once-daily prophylaxis of such patients with 40 mg of the low-molecular-weight heparin (LMWH) enoxaparin is at least as effective or more effective as prophylaxis with unfractionated heparin, and may be preferable in some populations. It is now being recommended that hospitals develop formal strategies that address the prevention of thromboembolic complications and that general medical patients at risk of VTE receive unfractionated heparin or LMWH.
肺栓塞是住院患者意外死亡的最常见原因之一，也是导致医疗事故诉讼的主要疾病之一。为了有效预防静脉血栓栓塞（VTE），医生必须评估患者的风险因素并据此对其风险进行分层。研究表明，普通内科患者最容易患深静脉血栓形成。研究还表明，每天一次用40毫克低分子肝素（LMWH）依诺肝素对这类患者进行预防，至少与用普通肝素预防一样有效或更有效，并且在某些人群中可能更可取。现在建议医院制定正式的策略来预防血栓栓塞并发症，并且有VTE风险的普通内科患者应接受普通肝素或低分子肝素治疗。
