Petty John K
Section of Pediatric Surgery, Department of General Surgery, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina 27157.
Semin Pediatr Surg. 2017 Feb;26(1):14-20. doi: 10.1053/j.sempedsurg.2017.01.001. Epub 2017 Jan 5.
Although venous thromboembolism (VTE) occurs in less than 1% of hospitalized pediatric trauma patients, care providers must make decisions about VTE prophylaxis on a daily basis. The consequences of VTE are significant; the risks of developing VTE are variable; and the effectiveness of prophylaxis against VTE is not conclusive in children. While the value of VTE prophylaxis is well defined in adult trauma care, it is unclear how this translates to the care of injured children. This review evaluates the incidence and risks of VTE in pediatric trauma and assesses the merits of prophylaxis in children. Pharmacologic prophylaxis against VTE is a reasonable strategy in critically injured adolescent trauma patients. Further study is needed to establish the risks and benefits of VTE prophylaxis across the spectrum of injured children.
尽管静脉血栓栓塞症(VTE)在住院的小儿创伤患者中发生率不到1%,但医护人员必须每天就VTE预防措施做出决策。VTE的后果很严重;发生VTE的风险各不相同;而且儿童预防VTE的有效性尚无定论。虽然VTE预防措施在成人创伤护理中的价值已得到明确界定,但尚不清楚这如何转化为对受伤儿童的护理。本综述评估了小儿创伤中VTE的发生率和风险,并评估了儿童预防措施的优点。对严重受伤的青少年创伤患者进行药物预防VTE是一种合理的策略。需要进一步研究以确定在整个受伤儿童群体中VTE预防措施的风险和益处。