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[肺手术术后肺栓塞的预防与管理]

[Prophylaxis and management of postoperative pulmonary embolism in lung surgery].

作者信息

Sano Yoshifumi

机构信息

Department of Cancer and Thoracic Surgery, Okayama University Graduate School of Medicine, Okayama, Japan.

出版信息

Kyobu Geka. 2008 Jul;61(8 Suppl):721-5.

Abstract

Venous thromboembolism (VTE) is the common condition of disease specified as deep vein thrombosis (DVT) or pulmonary embolism (PE), and PE is well known as one of the most important acute and chronic complications after thoracic surgery. Clinical guidelines recommend the use of low dose unfractionated heparins in the treatment and prevention of VTE, in addition to non-pharmacological interventions such as elastic stockings or intermittent sequential pneumatic compression (ISPC) aimed at reducing thrombotic risk. Even in nonsurgical patients, anticoagulation therapy carries a potential risk of exacerbating a bleeding complication, whereas administration of anticoagulation drugs in surgical patients carries an even greater risk of bleeding complications. In addition, use of inferior vena cava (IVC) filters or thrombolytic agents in patients with surgery also remains controversial. Prophylaxis in patients with VTE has received recommendations in many clinical guidelines, however, when the VTE is suspected, immediate and accurate diagnosis and appropriate treatment become important.

摘要

静脉血栓栓塞症(VTE)是一种常见疾病,具体表现为深静脉血栓形成(DVT)或肺栓塞(PE),而PE是胸外科手术后最重要的急慢性并发症之一。临床指南建议,除使用弹力袜或间歇性序贯气压装置(ISPC)等旨在降低血栓形成风险的非药物干预措施外,还应使用低剂量普通肝素治疗和预防VTE。即使在非手术患者中,抗凝治疗也有加重出血并发症的潜在风险,而在手术患者中使用抗凝药物则有更高的出血并发症风险。此外,在手术患者中使用下腔静脉(IVC)滤器或溶栓药物也仍存在争议。VTE患者的预防在许多临床指南中都有相关建议,然而,当怀疑有VTE时,立即进行准确诊断和适当治疗就变得很重要。

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