Paiement G D, Mendelsohn C
University of California at San Francisco, USA.
Orthopedics. 1997 Feb;20 Suppl:7-9.
Venous thromboembolism is responsible for 500,000 deaths annually in industrialized countries. It is probably the most common preventable cause of death in elective orthopedic surgery patients. Rates of deep vein thrombosis (DVT) and fatal pulmonary embolism (PE) in unprotected orthopedic patient populations are high. The overall DVT rate is > 40% in patients undergoing hip or knee arthroplasty or suffering from multiple injuries. The proximal DVT rate for these patients is > or = 15%, and the fatal PE rate is > or = 1%. Risk factors associated with venous thromboembolism are related to the vascular injury, activation of blood coagulation, and venous stasis. Lower extremity orthopedic procedures carry a risk greater than that of surgery itself. Thus, orthopedic patients are at high risk for venous thromboembolic conditions. A systematic assessment of this risk should be performed in every patient, and an appropriate management plan should be implemented.
在工业化国家，静脉血栓栓塞每年导致50万人死亡。它可能是择期骨科手术患者中最常见的可预防死亡原因。在未采取预防措施的骨科患者群体中，深静脉血栓形成（DVT）和致命性肺栓塞（PE）的发生率很高。接受髋关节或膝关节置换术或多处受伤的患者中，总体DVT发生率>40%。这些患者的近端DVT发生率>或=15%，致命性PE发生率>或=1%。与静脉血栓栓塞相关的危险因素与血管损伤、凝血激活和静脉淤滞有关。下肢骨科手术的风险大于手术本身。因此，骨科患者发生静脉血栓栓塞性疾病的风险很高。应对每位患者进行这种风险的系统评估，并实施适当的管理计划。
