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创伤患者药理学静脉血栓栓塞治疗方案的制定

Development of a Pharmacologic Venous Thromboembolism Protocol for Trauma Patients.

作者信息

Coolidge Will

机构信息

Avera McKennan Hospital and University Health Center, Sioux Falls, South Dakota.

出版信息

S D Med. 2018 Oct;71(10):438-444.

Abstract

Despite significant advances in the prevention and treatment of venous thromboembolism (VTE), deep venous thromboembolism (DVT) and pulmonary (PE) remains the most common preventable cause of hospital death to date, accounting for approximately 150,000 to 200,000 deaths per year in the U.S. Surgical trauma patients remain a challenging group of patients who are at high risk of developing VTE. VTE prophylaxis guidelines for trauma patients can be found in the 2016 CHEST guidelines, 2002 EAST Trauma guidelines, and the 2016 VTE prophylaxis in neurocritical care patients Neurocritical Care Society guidelines. In spite of the availability of these guidelines, the well-established risk factors and the availability of safe and effective prophylactic agents, numerous audits have demonstrated that appropriate thromboembolism prophylaxis is not being offered to large numbers of trauma surgical patients. In this article, a brief review of literature and the various society guidelines were completed. The goal of this paper is to develop a protocol for VTE prophylaxis in the trauma patient population to provide optimal care for patients.

摘要

尽管在静脉血栓栓塞症(VTE)的预防和治疗方面取得了重大进展,但深静脉血栓形成(DVT)和肺栓塞(PE)仍是迄今为止医院死亡最常见的可预防原因,在美国每年约导致15万至20万人死亡。外科创伤患者仍然是一组具有挑战性的患者群体,他们发生VTE的风险很高。创伤患者的VTE预防指南可在2016年美国胸科医师学会(CHEST)指南、2002年东部创伤外科学会(EAST)创伤指南以及2016年神经重症监护患者VTE预防神经重症监护学会指南中找到。尽管有这些指南,有公认的风险因素,且有安全有效的预防药物,但大量审计表明,许多创伤外科患者未得到适当的血栓栓塞预防措施。在本文中,完成了对文献和各种学会指南的简要综述。本文的目的是制定一项针对创伤患者群体的VTE预防方案,为患者提供最佳护理。

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