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静脉血栓栓塞是术后对病人的一个重大的威胁.预防的真正目标在于致命性肺栓塞.Kakar等证实,小剂量肝素不仅可以降低深静脉血栓形成的发病率,还可以减少肺栓塞的发生率和死亡率.且无应用华法令作治疗性抗凝时并发的大出血并发症的危险.《新英格兰医学杂志》和《循环》编者指出,在美国,对所有40岁以上作胸腹部手术者,常规应用小剂量肝素预防,每年可拯救4000~8000名病人的生命.但上述观点尚未被外科界广泛地接受且有争论.为了明确争论的实质,作者就深静脉血栓形成及肺栓塞的自然历史、早期诊断技术的精确性以及已发表的支持机械性与化学性预防措施的资料作了复习.问题的范围一般公认,在普外外科病人中,致命性肺栓塞的危险是低的.在10个大的美国医学中
Venous thromboembolism is a major postoperative threat to the patient and the real goal of prevention is fatal pulmonary embolism. Kakar et al. Demonstrated that low-dose heparin not only reduces the incidence of deep venous thrombosis but also reduces the incidence of pulmonary embolism And mortality without the risk of major bleeding complications associated with the use of warfarin for therapeutic anticoagulation The New England Journal of Medicine and the Editor of Circulation point out that in the United States all those over the age of 40 who have undergone thoracic and abdominal surgery, Routine use of low-dose heparin prophylaxis can save 4,000 to 8,000 patients each year, but this view has not been widely accepted by the surgical community and is controversial.In order to clarify the substance of the controversy, the author of the deep vein thrombosis and natural history of pulmonary embolism , The accuracy of early diagnostic techniques, and published data on supporting mechanical and chemical preventive measures.The scope of the problem is generally recognized as having a low risk of fatal pulmonary embolism in general surgical patients.At 10 A big American medicine