中国实用外科杂志

中国实用外科杂志

• 专题笔谈 • 上一篇    下一篇

静脉血栓栓塞症抗凝原则及并发症处理

史振宇，符伟国   

  1. 复旦大学附属中山医院血管外科，上海200032
  • 出版日期:2021-12-01

  • Online:2021-12-01

摘要： 静脉血栓栓塞症（VTE）包括深静脉血栓（DVT）和肺栓塞（PE），其基础治疗为抗凝。对于VTE风险评估中高危而且没有出血风险的病人推荐进行预防性抗凝。已经发生的VTE在评估低出血风险后更加需要进行长期治疗性抗凝。常见抗凝药物包括普通肝素、低分子肝素、华法林、利伐沙班为代表的直接口服抗凝药、磺达肝癸钠和阿加曲班。不同抗凝药物有各自的适应人群、注意事项和推荐剂量。对于血栓复发风险高的病人建议延长抗凝。

关键词: 静脉血栓栓塞症, 抗凝, 抗凝药物, 复发, 出血

Abstract: Anticoagulation principles of venous thromboembolism and treatment of complications        SHI Zhen-yu, FU Wei-guo. Department of Vascular Surgery, Zhongshan Hospital, Fudan Univeristy, Shanghai 200032, China
Corresponding author：FU Wei-guo, E-mail:fu.weiguo@zs-hospital.sh.cn
Abstract    Venous thromboembolism（VTE）includes deep vein thrombosis（DVT）and pulmonary embolism（PE）.Anticoagulation is the basic treatment of VTE.For patients with medium to high VTE risks and low bleeding risk，prophylactic anticoagulation is recommended.For attack of acute VTE events，long term therapeutic anticoagulation is mandatory in case there is low bleeding risk.Common anticoagulants include unfractionated heparin，low molecular weight heparin，warfarin, direct oral anticoagulant represented by rivaroxaban，fondaparinux and argatroban.This review introduced the indication，caution and recommended dosage of different anticoagulants. Extended anticoagulation is proposed for patients with high VTE recurrence risk.

Key words: venous thromboembolism, anticoagulation, anticoagulant, recurrence, bleeding