Abstract: Prevention and treatment of venous thromboembolism during the perioperative period in bariatric surgery                   ZHANG Pin. Department of Bariatric & Metabolic Surgery，Shanghai Jiao Tong University Affiliated Sixth People’s Hospital，Shanghai 200233，China
Abstract    Venous thromboembolism (VTE) is a major cause of morbidity and mortality in bariatric surgery. Patients with obesity and related metabolic disorders are at an increased risk for the development of thromboembolic disease. Besides，effects of pneumoperitoneum and position，prolonged bed rest may induce VTE. There is no generally accepted guidance or ideal prevention options for VTE in bariatric surgery. Hence doctors and nurses should have a sense of prevention and collaborate with patients. The author recommend the preoperative risk assessment for VTE，and provide mechanical (intermittent pneumatic compression，IPC and/or graduated compression stockings，GCS) or pharmacological prophylaxis for patients if necessary. Multi-disciplinary team approach  and ERAS should be encouraged. If VTE is suspected，early diagnosis and therapy is of great importance to reduce harmful consequence of VTE.

Key words: venous thromboembolism, prevention, obesity, enhanced recovery after surgery（ERAS）

摘要： 静脉血栓栓塞症（VTE）是减重手术后发生并发症和病人死亡的主要因素之一。病人因肥胖及相关代谢紊乱导致VTE发病风险高，术中气腹、特殊体位，术后卧床等因素均可能诱发VTE。目前，已发布的指南中尚无预防减重及代谢手术并发VTE的理想方案，因而要求医护人员具有预防意识，与病人共同协作。建议入院后进行VTE风险分级评估，根据病情采取机械性预防（气囊加压或弹力袜）、药物预防等措施，加强多学科合作，深入贯彻加速康复外科理念，强调术后早期运动。对于术后出现VTE的病人，强调早诊断、早治疗原则，可有效降低VTE的危害。

关键词: 静脉血栓栓塞症, 预防, 肥胖, 加速康复外科