围手术期静脉血栓栓塞症预防和管理几个关键问题
近年来围手术期静脉血栓栓塞症(VTE)逐渐引起我国外科医生的关注。2016年我国发布了第一部普通外科围手术期血栓预防与管理指南,旨在更好地推动中国普通外科医师对围手术期VTE预防和管理的重视和认识。但是外科医师在认识上还存在一定的误区。亚洲人群VTE发生率低于欧美人群的传统观念应加以纠正和更新;不同类型的普通外科手术VTE发生情况存在各自特点,外科医师应有所了解。VTE危险分层中,指南推荐的风险评估工具不能随意简化,并注意根据合理评估正确选择抗凝预防措施。在转化医学和加速康复外科等理念的引导下,VTE预防也必将取得更好的效果。
Several critical issues of prevention and management for the perioperative venous thrombosis QIN Xin-yu,LIU Feng-lin. Department of General Surgery,Zhongshan Hospital, Fudan University;Research Institute of General Surgery of Fudan University,Shanghai 200032,China
Corresponding author:QIN Xin-yu,E-mail:qin.xinyu@
zs-hospital.sh.cn
Abstract Perioperative venous thromboembolism has attracted Chinese surgeons’ attention recently. In 2016, China published the first guideline of perioperative thrombosis prevention and management for general surgery, aiming at raising the awareness and attention of local surgeons. Several critical problems of the thromboprophylaxis have been issued, for example, the traditional belief that the VTE incidence of Asian population is lower than that of western population should be rejudged. Surgeons should have ideas that the occurrence of the thrombosis is characteristic according to each independent type of specific surgical procedure. Besides, it shold be emphasized that the risk assessment tool recommended by the guideline could not be simplified casually while performing risk stratification of VTE, and it should also be insisted that surgeons should pay attention to different methods during the process of anticoagulant prophylaxis. Finally, based on the progress of translational medicine and ERAS, the quality of the thromboprophylaxis in China would be improved in the future.
perioperative period;venous thromboembolism;prevention / quality improvement
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