Moser K M
Urol Clin North Am. 1983 Feb;10(1):101-8.
There is no question that a substantial risk of venous thrombosis, pulmonary embolism, and lethal pulmonary embolism exist among patients undergoing urologic surgery. Available prophylactic strategies should sharply reduce this risk. Acceptable treatment options exist for patients who develop thromboembolism despite, or in the absence of, prophylaxis. Accurate diagnosis, however, is essential in order to select the most appropriate option. Finally, it should be noted that in making judgments, the comments provided can offer only general guidelines for patients undergoing urologic surgery. Individual patients may have a particular constellation of circumstances that dictates a rational deviation in decision-making from these general guidelines. However, one pivotal decision from which there should be not deviation without extraordinarily special justification is that some form of prophylaxis for deep venous thrombosis should be offered to all patients undergoing major urologic surgical procedures.
毫无疑问，接受泌尿外科手术的患者存在静脉血栓形成、肺栓塞和致死性肺栓塞的重大风险。现有的预防策略应能大幅降低这种风险。对于尽管接受了预防措施但仍发生血栓栓塞或未接受预防措施而发生血栓栓塞的患者，存在可接受的治疗选择。然而，准确的诊断对于选择最合适的治疗方案至关重要。最后，应该指出的是，在做出判断时，所提供的意见仅可为接受泌尿外科手术的患者提供一般指导原则。个别患者可能有特定的情况组合，这决定了在决策时应合理偏离这些一般指导原则。然而，在没有极其特殊的理由的情况下，不应偏离的一个关键决定是，应为所有接受重大泌尿外科手术的患者提供某种形式的深静脉血栓形成预防措施。
