Jackson Philip C, Morgan Judith M
Anaesthetic Department, Sheffield Children's NHS Trust, Western Bank, Sheffield, UK.
Paediatr Anaesth. 2008 Jun;18(6):478-87. doi: 10.1111/j.1460-9592.2008.02597.x.
Venous thromboembolic (VTE) events can occur in children at the time of surgery where a patient has associated prothrombotic risk factors. There is currently little advice available to anesthetists on how to assess the risks and provide prophylaxis.
AIM/OBJECTIVE: To increase awareness of thrombosis in the perioperative pediatric patient, and to give some guidance when considering prophylaxis in this group.
METHOD/RESULTS: A guideline outlining risk factors for venous thromboembolism in patients presenting for surgery was written as a flowchart. Recommendations for low risk patients was early mobilization and good hydration; for moderate risk patients having major general surgery to include physical prophylaxis where size permits, i.e. elastic stockings and compression devices; for high-risk patients undergoing major orthopaedic or general surgery to also receive prophylactic low molecular weight heparin enoxaparin 0.5 mg x kg(-1) b.d.
Children with multiple risk factors for VTE should be considered for prophylactic measures when presenting for prolonged major surgery.
静脉血栓栓塞（VTE）事件可发生于伴有血栓形成风险因素的手术患儿。目前，麻醉医生在如何评估风险及提供预防措施方面几乎没有可参考的建议。
提高对围手术期儿科患者血栓形成的认识，并在考虑对该群体进行预防时提供一些指导。
方法/结果：编写了一份以流程图形式呈现的指南，概述手术患者静脉血栓栓塞的风险因素。对于低风险患者，建议早期活动和充分补液；对于接受大型普通外科手术的中度风险患者，在尺寸允许的情况下进行物理预防，即使用弹力袜和加压装置；对于接受大型骨科或普通外科手术的高风险患者，还应接受预防性低分子肝素依诺肝素，剂量为0.5毫克/千克，每日两次。
对于存在多种VTE风险因素的儿童，在进行长时间大型手术时应考虑采取预防措施。
