骨科深静脉血栓的预防治疗研究进展论文.pdfVIP

重庆医科大学硕士研究生学位论文 骨科深静脉血栓的预防治疗研究进展 摘要 深静脉血栓(Deepvenousthrombosis,DVT)作为骨科术后最常见的 并发症，在临床中越来越被重视, 目前存在很多深静脉血栓的防治指 南,但各个指南对血栓预防药物的选择以及使用时机均缺少高等级的 证据支持。而抗血栓药物又往往伴随出血风险，需引起足够重视。本 文通过对深静脉血栓形成的三大要素：静脉血流滞缓、静脉壁损伤和 血液高凝状态进行分析，阐述了骨科高深静脉血栓发病率原因。同时 将骨科深静脉血栓危险因素分为强、中、弱三个等级，并列举了常见 发病人群。随后本文对深静脉血栓预防采用的物理和药物措施进行了 逐一分析，通过对比新型抗凝药物和传统抗凝药物，大型骨科术后的 可选磺达肝葵钠抗凝，而膝关节置换术更推荐伐沙班，仍不建议将阿 司匹林与华法林用作常规抗凝治疗。对于因下肢软组织创伤而采用石 膏绷带制动的患者，通常忽略其较高的静脉血栓发病风险，所以，我 们建议，必要时也需使用抗凝药物。对于下肢长骨骨折的患者，尽早 恢复肢体长度并通过手术固定能有效降低静脉血栓的发生率。对于髋、 膝关节置换术后患肢，必要时延长抗凝疗程可获得更好收益。 关键词:骨科，深静脉血栓，预防 1 万方数据 重庆医科大学硕士研究生学位论文 PROGRESSOFPREVENTIONONORTHOPEDIC DEEPVENOUSTHROMBOSIS ABSTRACT Deepveinthrombosisasthemostcommoncomplicationoforthopedic surgery,more andmore attentioninthe clinic,atpresentthere arealotof deep vein thrombosis prevention guide, but the various guidelines for thromboprophylaxis drug selection anduse of time are the lack of a high level of evidence to support . The antithrombotic drugs is often accompanied by bleeding risk, need adequate attention. In this paper, the threeelementsofdeepveinthrombosis venousbloodstagnation,veinwall damage and hypercoagulable state analysis, elaborated the incidence of venous thrombosis in orthopedicprofound reasons. While risk factors for deep vein thrombosis orthopedic divided into strong, medium and weak three grades,andcitedthe incidenceofcommonpeople. Inthispaper, the physical and the subsequent deep vein thrombosis prophylaxis drug measures were adopted to analyze, by comparing the new anticoagulant drugs and traditional anticoagulants,