Schmidt J, Hackenbroch M H
Klinik und Poliklinik für Orthopädie der Universität zu Köln, Germany.
Arch Orthop Trauma Surg. 1995;114(4):226-8. doi: 10.1007/BF00444268.
In recent years the problem of deep venous thrombosis (DVT) in outpatients and discharged patients has grown into a medical and juridical problem. In traumatology certain recommendations and statistical material exist: similar recommendations were made by the Berufsverband der Arzte für Orthopädie, Germany, pointing out the lack of sufficient statistical material. With the present study we tried to evaluate the actual management of DVT in discharged patients or outpatients in leading orthopaedic hospitals. The results from December 1993 reveal an inhomogeneous procedure which does not precisely follow the above recommendations. However, most orthopaedic surgeons agree that either general or individual means to prevent DVT should be available for ambulatory and discharged patients with plaster immobilisation of the leg according to presently accepted standards, i.e. low-dose heparin or low-molecular-weight heparins. Reduced weight-bearing, in contrast, is considered not to require preventive heparinisation to any great extent.
近年来，门诊患者和出院患者的深静脉血栓形成（DVT）问题已演变成一个医学和法律问题。在创伤学领域，存在一些建议和统计资料：德国骨科医生职业协会也提出了类似建议，指出缺乏足够的统计资料。通过本研究，我们试图评估主要骨科医院出院患者或门诊患者DVT的实际管理情况。1993年12月的结果显示，其程序并不统一，并未严格遵循上述建议。然而，大多数骨科医生一致认为，根据目前公认的标准，对于腿部石膏固定的门诊和出院患者，应采用一般或个体化的方法预防DVT，即使用低剂量肝素或低分子量肝素。相比之下，减轻负重被认为在很大程度上不需要预防性肝素化。
