Grabo Daniel J, Seery Jason M, Bradley Matthew, Zakaluzny Scott, Kearns Michel J, Fernandez Nathanial, Tadlock Matthew
Joint Trauma System, 3698 Chambers Pass, Joint Base San Antonio, Fort Sam Houston, TX.
Mil Med. 2018 Sep 1;183(suppl_2):133-136. doi: 10.1093/milmed/usy072.
The nature of many combat wounds puts patients at a high risk of developing deep venous thrombosis (DVT) and pulmonary embolism (PE), which fall under the broader disease category of venous thromboembolism (VTE). In addition to the hypercoagulable state induced by trauma, massive injuries to the extremities, prolonged immobility, and long fixed wing transport times to higher echelons of care are unique risk factors for venous thromboembolism in the combat-injured patient. These risk factors mandate aggressive prophylaxis for DVT and PE that can effectively be achieved by the use of lower extremity sequential compression devices and low dose unfractionated heparin or low molecular weight heparin. In addition, inferior vena cava filters are often used for PE prophylaxis when chemical DVT prophylaxis fails or is contraindicated. The following Department of Defense (DoD) Joint Trauma System (JTS) Clinical Practice Guideline (CPG) discusses the current recommendations for the prevention of DVT and PE including the use of inferior vena cava filters (IVCFs).
许多战伤的性质使患者处于发生深静脉血栓形成（DVT）和肺栓塞（PE）的高风险中，这两种病症都属于更广泛的静脉血栓栓塞（VTE）疾病范畴。除了创伤引起的高凝状态外，四肢的大面积损伤、长期制动以及转送至更高级别医疗机构的固定翼飞机长途运输时间，都是战伤患者发生静脉血栓栓塞的独特风险因素。这些风险因素要求积极预防DVT和PE，通过使用下肢序贯加压装置以及低剂量普通肝素或低分子量肝素能够有效实现这一目标。此外，当化学性DVT预防措施失败或存在禁忌时，下腔静脉滤器常被用于预防PE。以下美国国防部（DoD）联合创伤系统（JTS）临床实践指南（CPG）讨论了预防DVT和PE的当前建议，包括下腔静脉滤器（IVCFs）的使用。
