Reilly D T
Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, Massachusetts.
Acta Chir Scand Suppl. 1989;550:115-8.
Deep vein thrombosis and pulmonary embolism are significant hazards of surgery, especially in orthopedic procedures. However, the true incidence of these complications is unknown. Many surgeons are now using prophylactic methods to prevent the postoperative occurrence of thromboembolic disease. Pneumatic compression devices are recommended in some instances, especially in cases where increased bleeding could be devastating. Several pharmacologic agents are also used, alone or in combination with pneumatic devices. These include subcutaneous heparin, warfarin, dextran, and aspirin. Each agent has advantages and disadvantages. The US National Institutes of Health (NIH) and numerous ongoing clinical trials are attempting to establish recommendations and guidelines for the use of prophylaxis against postoperative deep vein thrombosis and pulmonary embolism.
深静脉血栓形成和肺栓塞是手术的重大风险，尤其是在骨科手术中。然而，这些并发症的真实发生率尚不清楚。现在许多外科医生正在使用预防方法来防止术后血栓栓塞性疾病的发生。在某些情况下，推荐使用气动压迫装置，特别是在出血增加可能造成严重后果的病例中。也单独或与气动装置联合使用几种药物。这些药物包括皮下注射肝素、华法林、右旋糖酐和阿司匹林。每种药物都有优缺点。美国国立卫生研究院（NIH）和众多正在进行的临床试验正在试图制定针对术后深静脉血栓形成和肺栓塞预防用药的建议和指南。
