Martin Sharolyn L, Tellez M Geno
Department of Emergency Medicine, John Peter Smith Hospital, Ft. Worth, Texas, USA.
J Emerg Trauma Shock. 2011 Jul;4(3):427-9. doi: 10.4103/0974-2700.83880.
Trauma victims with multisystem injuries are at risk for the development of deep vein thrombosis and pulmonary embolus (PE). The use of thrombolytic therapy remains very controversial and not well-documented in both the postsurgical and trauma subset of patients. Major trauma, surgery or head injury have been noted as absolute contraindications to thrombolysis in acute myocardial infarction. The decision to utilize thrombolytic therapy cannot be algorithmic; it must be based on the assessment findings for each individual patient. The risk to benefit ratio should be the major consideration to ensure the best possible outcome is granted. Treating injured patients experiencing high-risk PE causing an immediate threat to life may necessitate forming a comparative view of the adverse events associated with thrombolytic medications.
患有多系统损伤的创伤患者有发生深静脉血栓形成和肺栓塞（PE）的风险。在术后患者和创伤患者亚组中，溶栓治疗的使用仍然存在很大争议且记录不完善。严重创伤、手术或头部损伤已被视为急性心肌梗死溶栓的绝对禁忌症。使用溶栓治疗的决定不能基于固定算法；它必须基于对每个患者的评估结果。风险效益比应是主要考虑因素，以确保获得最佳可能结果。治疗因高危PE而对生命构成直接威胁的受伤患者可能需要对与溶栓药物相关的不良事件形成比较观点。
