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内科患者静脉血栓栓塞的预防

Prophylaxis of venous thromboembolism in medical patients.

作者信息

Criado-García J

机构信息

Unidad de Enfermedad Tromboembólica Venosa, Unidad de Gestión Clínica de Medicina Interna, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofía, Universidad de Córdoba, Córdoba, España.

出版信息

Rev Clin Esp. 2020 Sep 18. doi: 10.1016/j.rce.2020.07.005.

Abstract

Venous thromboembolism (VTE) is a prevalent and serious complication in hospitalized medical patients. Pulmonary embolism is the most common preventable cause of hospital death. VTE extends hospitalization, with a higher resource consumption and an increase in healthcare costs. Risk factors for VTE include intrinsic factors and those related to hospitalization. It is important to know and to identify these factors at the moment of hospital admission and during the course of disease. VTE prophylaxis has demonstrated to be an efficient and effective action. Its implementation reduces life-threatening pulmonary embolism, symptomatic deep vein thrombosis and death rate three months after discharge. An individual and detailed assessment of prophylaxis risk-benefit is a priority. In our country, low molecular weight heparins are still the first option for VTE pharmacological prophylaxis. In those patients at high risk of bleeding or in whom anticoagulation is contraindicated mechanical methods could be used.

摘要

静脉血栓栓塞症(VTE)是住院内科患者中一种常见且严重的并发症。肺栓塞是医院死亡最常见的可预防原因。VTE会延长住院时间,导致更高的资源消耗和医疗费用增加。VTE的危险因素包括内在因素和与住院相关的因素。在入院时和疾病过程中了解并识别这些因素很重要。VTE预防已被证明是一项有效且高效的措施。其实施可降低出院后三个月内危及生命的肺栓塞、有症状的深静脉血栓形成和死亡率。对预防措施进行个体化和详细的风险效益评估是当务之急。在我国,低分子肝素仍是VTE药物预防的首选。对于那些出血风险高或抗凝治疗禁忌的患者,可采用机械方法。

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