Abstract：
The incidence and mortality of venous thromboembolism (VTE) are high in critically ill patients, and there is still a risk of VTE and bleeding after the use of fixed-dose low molecular weight heparin (LMWH) for prophylaxis. The level of anti-factor Xa is not up to standard after LMWH prophylaxis in patients with surgery or trauma. The condition of critically ill patients is complicated, and the proportion of patients with low antithrombin III is high, which can affect the prophylactic efficacy of LMWH and contribute to VTE occurrence. There is currently no consensus on whether adjusting LMWH dose according to anti-factor Xa levels can reduce VTE occurrence in critically ill patients. High-quality multicenter randomized controlled studies are needed in the future to establish new approaches for precise prevention of VTE in critically ill patients.
摘要：
危重病人静脉血栓栓塞症(VTE)的发病率和死亡率高,使用固定剂量低分子量肝素（LMWH）进行预防后，仍有发生VTE和出血的风险。在手术或创伤患者中，LMWH预防后，抗因子Xa的水平不达标。危重病人病情复杂,抗凝血酶III低的患者比例很高，这可能影响LMWH的预防功效并有助于VTE的发生。目前对于根据抗因子Xa水平调整LMWH剂量是否可以减少危重病患者的VTE发生率尚无共识。未来需要高质量的多中心随机对照研究，以建立精确预防危重患者VTE的新方法。
