Ruskin Keith J
Department of Anesthesia and Critical Care, University of Chicago School of Medicine, Chicago, Illinois, USA.
Curr Opin Anaesthesiol. 2018 Apr;31(2):215-218. doi: 10.1097/ACO.0000000000000567.
Deep vein thrombosis (DVT) and pulmonary embolus are major causes of hospital-related morbidity and mortality, and are recognized as complications in patients with traumatic injury. Despite the significant morbidity and mortality associated with DVTs, prophylaxis and treatment are still not well understood and remain the subject of research and debate.
Elements of the patient's history and physical examination, along with thromboelastography, can be used to predict patients who are at greatest risk of DVT and venous thromboembolism (VTE). Novel assays and biomarkers hold promise for more accurate evaluation of coagulation status. Patients with traumatic injury are routinely treated with either mechanical or pharmacological treatments to prevent DVT, and a growing body of evidence suggests that DVT prophylaxis should be initiated as early as possible in a patient's hospital course.
In trauma patients with traumatic injury, early identification and targeted VTE prophylaxis in trauma patients may prevent this life-threatening complication.
深静脉血栓形成(DVT)和肺栓塞是医院相关发病和死亡的主要原因,并且被认为是创伤性损伤患者的并发症。尽管DVT与显著的发病和死亡相关,但预防和治疗仍未得到充分理解,仍是研究和争论的主题。
患者的病史和体格检查要素,以及血栓弹力图,可用于预测DVT和静脉血栓栓塞(VTE)风险最高的患者。新型检测方法和生物标志物有望更准确地评估凝血状态。创伤性损伤患者通常采用机械或药物治疗来预防DVT,越来越多的证据表明,应在患者住院过程中尽早开始DVT预防。
在创伤性损伤的创伤患者中,早期识别并针对性地对创伤患者进行VTE预防可能预防这种危及生命的并发症。