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创伤患者可发生深静脉血栓形成(DVT)和肺栓塞(PE)。DVT和PE的发生与下述因素有关:外伤治疗时限制活动;静脉内皮受损;休克和(或)灌注不良可能引起的高凝状态。尽管关于静脉血栓栓塞的发生率,预防和诊断仍有争议,抗凝治疗对多数PE患者已成为常规疗法。当抗凝治疗有禁忌症或并发症时,可选择腔静脉中断(用Greenfield过滤)方法防止再发性或原发生PE。抗凝对DVT和PE是经典(标准)疗法,但可引起严重并发症。作者总结创伤合并PE患者的抗凝治疗经验,以确定并发症的发生率,确定适于早期施行腔静脉中断术的患者。
Trauma patients may develop deep venous thrombosis (DVT) and pulmonary embolism (PE). The occurrence of DVT and PE is associated with factors that limit activity during traumatic injury, damage to the venous endothelium, hypercoagulable conditions that may be caused by shock and / or poor perfusion. Although the incidence of venous thromboembolism, prevention and diagnosis is still controversial, anticoagulant therapy has become the routine therapy in most PE patients. When anticoagulant therapy has contraindications or complications, the choice of vena cava disruption (filtered by Greenfield) prevents recurrent or prostatic PE. Anticoagulation is a classic (standard) therapy for DVT and PE but can cause serious complications. The authors summarize the experience with anticoagulant therapy in patients with traumatic PE and in patients with PE to determine the incidence of complications and identify patients who are eligible for early IVC disruption.