From the Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA.
J Am Acad Orthop Surg. 2017 Dec;25(12):789-798. doi: 10.5435/JAAOS-D-15-00760.
Venous thromboembolism (VTE) prophylaxis is recommended for all patients undergoing total hip arthroplasty or total knee arthroplasty. The selection of an appropriate prophylaxis regimen represents a balance between efficacy and safety. To help orthopaedic surgeons select an appropriate VTE prophylaxis regimen for their patients, the American Academy of Orthopaedic Surgeons and the American College of Chest Physicians have developed guidelines. These guidelines do not recommend an optimal regimen, however. Rather, an individualized prophylaxis regimen that balances efficacy and safety is recommended for each patient, based on various risk factors. Because of a paucity of data and a lack of adequately powered head-to-head trials, implementing these guidelines can be challenging for the orthopaedic surgeon. Knowledge of the prophylaxis options and the VTE risk factors is paramount for developing an effective VTE prophylaxis algorithm for the surgeon's practice.
静脉血栓栓塞症（VTE）预防被推荐用于所有接受全髋关节置换术或全膝关节置换术的患者。选择合适的预防方案需要在疗效和安全性之间取得平衡。为了帮助骨科医生为其患者选择合适的 VTE 预防方案，美国矫形外科医师学会和美国胸科医师学会制定了指南。然而，这些指南并没有推荐一种最佳的方案。相反，建议根据各种风险因素，为每位患者制定个体化的预防方案，在疗效和安全性之间取得平衡。由于数据不足和缺乏充分有力的头对头试验，骨科医生实施这些指南具有挑战性。了解预防方案和 VTE 风险因素对于为医生的实践制定有效的 VTE 预防算法至关重要。
