Wendl-Soeldner M A, Moll C W I, Kammerlander C, Gosch M, Roth T
Department for Trauma Surgery, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria.
Z Gerontol Geriatr. 2014 Feb;47(2):95-104. doi: 10.1007/s00391-013-0595-4.
During the past decades, the number of hip fractures has been increasing steadily. Perioperative thromboprophylaxis has become a routine aspect in the care of geriatric hip fracture patients. In addition, a large proportion of these patients are already anticoagulated because of internistic comorbidities before they sustained the hip fracture. Although the management of preexisting anticoagulation in both orthopedic elective and emergency procedures is well reported, proximal femoral fractures are classified as "acute" and therefore represent neither of these two categories. In this study, we review the different options of handling preexisting anticoagulation and antiaggregation as well as perioperative thromboprophylaxis. The Innsbruck Algorithm for the management of anticoagulation in geriatric hip fracture patients suggests how perioperative bleeding risk can be minimized, while still addressing the underlying disease.
在过去几十年中，髋部骨折的数量一直在稳步增加。围手术期血栓预防已成为老年髋部骨折患者护理中的常规内容。此外，这些患者中有很大一部分在发生髋部骨折之前，由于内科合并症已经在接受抗凝治疗。尽管对于骨科择期手术和急诊手术中已有抗凝治疗的管理已有充分报道，但股骨近端骨折被归类为“急性”骨折，因此不属于这两类中的任何一种。在本研究中，我们回顾了处理已有抗凝和抗聚集治疗以及围手术期血栓预防的不同选择。因斯布鲁克老年髋部骨折患者抗凝管理算法表明了如何在治疗基础疾病的同时，将围手术期出血风险降至最低。
