Department of Orthopaedic Surgery and Sports Medicine, University of South Carolina School of Medicine, Columbia, SC, USA.
J Am Acad Orthop Surg. 2013 Feb;21(2):108-17. doi: 10.5435/JAAOS-21-02-108.
Because deep vein thrombosis (DVT) can occur following orthopaedic procedures, knowledge of hereditary and acquired risk factors for DVT is essential. Hereditary forms of thrombophilia include factor V Leiden and prothrombin G20210A mutations, and deficiencies of antithrombin III, protein C, and protein S. Acquired risk factors include but are not limited to trauma, immobilization, and surgical procedures. In general, athletes have a low risk of venous thrombosis; however, this population is exposed to many acquired thrombogenic risk factors, including hemoconcentration, trauma, immobilization, long-distance travel, and the use of oral contraceptives. Thus, orthopaedic surgeons should consider screening athletes for thrombogenic risk factors, including history of venous thrombosis, hypercoagulable disorders, or high altitude exercise, during preparticipation physicals and preoperative examinations. If a patient is determined to be at high risk of DVT, preventive measures such as physical antithrombotic measures and/or low-molecular-weight heparin should be instituted. If an athlete develops a DVT, a risk factor assessment should be conducted along with anticoagulation treatment in accordance with the American College of Chest Physicians guidelines.
由于深静脉血栓形成（DVT）可能发生在骨科手术后，因此了解 DVT 的遗传和获得性危险因素至关重要。遗传性血栓形成倾向包括因子 V 莱顿和凝血酶原 G20210A 突变，以及抗凝血酶 III、蛋白 C 和蛋白 S 的缺乏。获得性危险因素包括但不限于创伤、固定和手术。一般来说，运动员患静脉血栓形成的风险较低；然而，该人群面临许多获得性血栓形成危险因素，包括血液浓缩、创伤、固定、长途旅行和口服避孕药的使用。因此，骨科医生应在参加体育活动前的体检和术前检查中考虑筛查运动员的血栓形成危险因素，包括静脉血栓形成史、高凝状态疾病或高海拔运动史。如果患者被确定为 DVT 的高风险，应采取物理抗血栓措施和/或低分子量肝素等预防措施。如果运动员发生 DVT，应根据美国胸科医师学会指南进行危险因素评估和抗凝治疗。
