McNally Michael P, Burns Christopher J
Department of Surgery, Division of Colon and Rectal Surgery, National Naval Medical Center, Bethesda, MD 20889, USA.
Clin Colon Rectal Surg. 2009 Feb;22(1):34-40. doi: 10.1055/s-0029-1202884.
Venous thromboembolic disease, which includes deep vein thromboses as well as pulmonary emboli, can be a significant complication in the postoperative patient. In particular, colorectal patients often carry a higher risk for venous thromboembolism when compared with patients undergoing other operative procedures. Features unique to colorectal patients are the high incidence of inflammatory bowel disease or malignancy. Typically, these patients will undergo lengthy pelvic procedures, which also contribute to a cumulative risk of venous thrombosis. It is critical that all patients and the proposed operative procedure are appropriately risk stratified. Risk stratification allows for easier implementation of an appropriate prophylactic strategy. There are a wide range of safe and effective mechanical and pharmacologic measures available. The authors provide very specific recommendations, but note that clinical judgment plays a significant role.
静脉血栓栓塞性疾病，包括深静脉血栓形成以及肺栓塞，可能是术后患者的一个重要并发症。特别是，与接受其他手术的患者相比，结直肠手术患者发生静脉血栓栓塞的风险通常更高。结直肠患者独有的特征是炎症性肠病或恶性肿瘤的高发病率。通常，这些患者将接受长时间的盆腔手术，这也会增加静脉血栓形成的累积风险。对所有患者和拟行的手术进行适当的风险分层至关重要。风险分层有助于更轻松地实施适当的预防策略。有多种安全有效的机械和药物措施可供选择。作者提供了非常具体的建议，但指出临床判断起着重要作用。
