Sheth Neil P, Lieberman Jay R, Della Valle Craig J
Department of Orthopaedic Surgery, Rush University, Midwest Orthopaedics, 1725 West Harrison Street, Chicago, IL 60612, USA.
Orthop Clin North Am. 2010 Apr;41(2):273-80. doi: 10.1016/j.ocl.2010.02.001.
Deep venous thrombosis (DVT) is the end result of a complex interaction of events including the activation of the clotting cascade in conjunction with platelet aggregation. Patients undergoing major lower extremity orthopedic surgery, especially total joint arthroplasty (TJA), are at high risk for developing a postoperative DVT or a subsequent pulmonary embolus. Venous thromboembolic (VTE) prophylaxis, most commonly pharmacologic prophylaxis, has become the standard of care for patients undergoing elective TJA. However, the controversy between the efficacy of VTE prophylaxis and the increased risk for bleeding in the postoperative period continues to exist. This review addresses the controversy underlying VTE prophylaxis by outlining 2 guidelines and demonstrating the pros and cons of different DVT prophylaxis regimens based on the available evidence-based literature.
深静脉血栓形成（DVT）是一系列复杂事件相互作用的最终结果，这些事件包括凝血级联反应的激活以及血小板聚集。接受下肢大型骨科手术，尤其是全关节置换术（TJA）的患者，发生术后DVT或随后发生肺栓塞的风险很高。静脉血栓栓塞（VTE）预防，最常见的是药物预防，已成为接受择期TJA患者的护理标准。然而，VTE预防的有效性与术后出血风险增加之间的争议仍然存在。本综述通过概述2项指南并根据现有循证文献展示不同DVT预防方案的利弊，来探讨VTE预防背后的争议。
