Datta Indraneel, Ball Chad G, Rudmik Lucas, Hameed S Morad, Kortbeek John B
Department of Surgery, University of Calgary, Calgary, Canada.
J Trauma Manag Outcomes. 2010 Jan 6;4:1. doi: 10.1186/1752-2897-4-1.
Deep venous thrombosis prophylaxis is essential to the appropriate management of multisystem trauma patients. Without thromboprophylaxis, the rate of venous thrombosis and subsequent pulmonary embolism is substantial. Three prophylactic modalities are common: pharmacologic anticoagulation, mechanical compression devices, and inferior vena cava filtration. A systematic review was completed using PRISMA guidelines to evaluate the potential complications of DVT prophylactic options. Level one evidence currently supports the use of low molecular weight heparins for thromboprophylaxis in the trauma patient. Unfortunately, multiple techniques are not infrequently required for complex multisystem trauma patients. Each modality has potential complications. The risks of heparin include bleeding and heparin induced thrombocytopenia. Mechanical compression devices can result in local soft tissue injury, bleeding and patient non-compliance. Inferior vena cava filters migrate, cause inferior vena cava occlusion, and penetrate the vessel wall. While the use of these techniques can be life saving, they must be appropriately utilized.
深静脉血栓形成的预防对于多系统创伤患者的恰当治疗至关重要。若不进行血栓预防，静脉血栓形成及随后发生肺栓塞的几率相当高。常见的三种预防方式为：药物抗凝、机械压迫装置和下腔静脉滤器。使用PRISMA指南完成了一项系统评价，以评估深静脉血栓形成预防措施的潜在并发症。目前一级证据支持在创伤患者中使用低分子量肝素进行血栓预防。不幸的是，复杂的多系统创伤患者常常需要多种技术。每种方式都有潜在并发症。肝素的风险包括出血和肝素诱导的血小板减少症。机械压迫装置可导致局部软组织损伤、出血及患者不依从。下腔静脉滤器会移位、导致下腔静脉阻塞并穿透血管壁。虽然使用这些技术可挽救生命，但必须恰当应用。
