Abstract:
Deep venous thrombosis (DVT) has been characterized by a disorder of venous return caused by abnormal blood clotting in deep veins. It often occurs in the lower limbs and is a common complication in orthopaedics. Therefore, relevant professional organizations domestic and overseas had formulated and constantly updated relevant guidelines to prevent the occurrence of DVT. According to the management strategy of the guidelines, the incidence of DVT can be significantly reduced. However, due to the variety of fractures types, the guidelines cannot expound precautions and characteristics of DVT for all fracture types at present, and there are other related unresolved problems. For example, there is still a lack of consistent optimal strategies for the management of DVT following isolated lower extremity fractures with a higher incidence. The best anticoagulant strategies for patients with upper limb fractures, pediatric fractures, and those combined with other injuries are rarely described in orthopaedic guidelines, but such fractures are common in clinical orthopaedics. The long-term complications after DVT, such as post-thrombotic syndrome, are not well-understood. In the absence of clear guidance, orthopaedic surgeons often resort to empiric anticoagulation or conservative treatment, so the prevention effects of DVT are inconsistent. The purpose of this review is to summarize the characteristics of DVT events after isolated lower extremity fractures and to discuss the unsolved issues in the guidelines by reviewing the previous literature and tracing the history of DVT discovery, to provide more scientific and comprehensive recommendations for the prediction and prevention of DVT.
摘要:
深静脉血栓形成(DVT)的特征是深静脉异常凝血引起的静脉回流障碍。它通常发生在下肢,是骨科的常见并发症。因此,国内外相关专业机构制定并不断更新相关指南,以预防DVT的发生。根据《管理战略指引》,DVT的发生率可以显著降低。然而,由于骨折类型的多样性,目前指南不能阐述所有骨折类型DVT的预防措施和特点,还有其他相关的未解决的问题。例如,对于孤立性下肢骨折发病率较高的DVT,目前仍缺乏一致的最佳治疗策略.上肢骨折患者的最佳抗凝策略,小儿骨折,那些合并其他损伤很少在骨科指南中描述,但是这种骨折在临床骨科很常见。DVT后的长期并发症,比如血栓后综合征,不是很了解。如果没有明确的指导,骨科医生经常采取经验性抗凝或保守治疗,因此DVT的预防效果不一致。这篇综述的目的是总结孤立性下肢骨折后DVT事件的特征,并通过回顾以前的文献和追踪DVT发现的历史来讨论指南中尚未解决的问题。为DVT的预测和预防提供更科学、全面的建议。