Pągowska-Klimek Izabela
Department of Paediatric Anaesthesiology and Intensive Care, Warsaw Medical University, Warsaw, Poland.
Anaesthesiol Intensive Ther. 2020;52(4):316-322. doi: 10.5114/ait.2020.97599.
Perioperative antithrombotic prophylaxis in adults is widely recommended. In the past, it was believed that this does not concern the paediatric population. Recently, however, there has been growing evidence that the incidence of venous thromboembolism (VTE) in children is increasing and is probably underestimated. This is a result of advances in treatment of previously lethal conditions, wide use of central venous catheters, and improved awareness and diagnosis of VTE complications. However, large clinical trials assessing the efficacy and safety of antithrombotic treatment in children have not been conducted and there are not widely accepted protocols of perioperative prophylaxis. At the same time, there is a growing awareness of its sequelae: compartment syndrome, pulmonary embolism, pulmonary hypertension, post-thrombotic syndrome, cost, length of hospital stay, and mortality. Local recommendations based on observational studies, individual experience, and extrapolation from data of adults have emerged.
成人围手术期抗血栓预防措施已得到广泛推荐。过去，人们认为这与儿科人群无关。然而，最近有越来越多的证据表明，儿童静脉血栓栓塞症（VTE）的发病率正在上升，而且可能被低估了。这是由于以往致命疾病的治疗取得进展、中心静脉导管的广泛使用以及对VTE并发症的认识和诊断有所改善。然而，尚未开展评估儿童抗血栓治疗疗效和安全性的大型临床试验，也没有被广泛接受的围手术期预防方案。与此同时，人们对其后遗症的认识也在不断提高：骨筋膜室综合征、肺栓塞、肺动脉高压、血栓形成后综合征、成本、住院时间和死亡率。基于观察性研究、个人经验以及从成人数据推断得出的局部建议已经出现。
