摘要
腰椎椎体融合术手术部位存在神经根、脊髓等重要结构,加上术后需要较长的卧床时间,围手术期无有效抗凝机体内血液易呈高凝状态,血栓形成风险高,然而过度或过早的启动抗凝治疗有导致硬膜外血肿风险,对神经功能产生灾难性后果。本文总结了腰椎椎体融合术围手术期预防性抗凝的最新研究进展,特别对现有抗凝治疗方案的有效性、局限性以及凝血状态指标的监测与评价、抗凝方案选择及其依据等方面进行了详细的论述,为临床腰椎疾患围手术抗凝治疗提供全面、准确的诊疗思路。
Due to the existence of nerve root,spinal cord and other important structures in the surgical site of lumbar spine fusion and the long-time lying after the operation,the blood will be prone to hypercoagulability without effective anticoagulation during the perioperative period,and therefore the risk of thrombosis is high.However,too much or too early initiation of anticoagulant therapy carries a risk of epidural hematoma,with disastrous consequences for neurological function.This paper summarizes the latest research progress of prophylactic anticoagulation in the perioperative period of lumbar spine fusion.Focusing on the effectiveness and limitation of the existing anticoagulant therapy,the monitoring and evaluation of the coagulation state,the choice of anticoagulant therapy and its basis are discussed in detail.The paper is aimed to provide a comprehensive and accurate diagnosis and treatment for perioperative anticoagulation therapy of lumbar spine diseases.
作者
邹其声(综述)
欧阳汉斌
孙欣(审校)
ZOU Qi-sheng;OUYANG Han-bin;SUN Xin(Orthopedics Center,Affiliated Hospital of Guangdong Medical University,Zhanjiang 524001,Guangdong,CHINA)
出处
《海南医学》
CAS
2022年第13期1744-1747,共4页
Hainan Medical Journal
基金
广东省医学科学技术研究基金(编号:A2019104)
广东医科大学附属医院博士启动基金项目(编号:BJ201803)
广东省湛江市科技发展专项资金竞争性分配项目(编号:2020A01042)。
关键词
腰椎椎体融合术
围手术期
预防性抗凝
药物抗凝
物理抗凝
Lumbar spine diseases
Perioperative
Prophylactic anticoagulation
Chemical anticoagulation
Physical anticoagulation
