ImageVerifierCode 换一换
格式:PPT , 页数:21 ,大小:2.66MB ,
资源ID:163366      下载积分:5 金币
已注册用户请登录:
账号:
密码:
验证码:   换一换
  忘记密码?
三方登录: 微信登录   QQ登录  
下载须知

1: 本站所有资源如无特殊说明,都需要本地电脑安装OFFICE2007和PDF阅读器。
2: 试题试卷类文档,如果标题没有明确说明有答案则都视为没有答案,请知晓。
3: 文件的所有权益归上传用户所有。
4. 未经权益所有人同意不得将文件中的内容挪作商业或盈利用途。
5. 本站仅提供交流平台,并不能对任何下载内容负责。
6. 下载文件中如有侵权或不适当内容,请与我们联系,我们立即纠正。
7. 本站不保证下载资源的准确性、安全性和完整性, 同时也不承担用户因使用这些下载资源对自己和他人造成任何形式的伤害或损失。

版权提示 | 免责声明

本文(如何预防脊柱手术后静脉血栓.ppt)为本站会员(奥沙丽水)主动上传,三一文库仅提供信息存储空间,仅对用户上传内容的表现方式做保护处理,对上载内容本身不做任何修改或编辑。 若此文所含内容侵犯了您的版权或隐私,请立即通知三一文库(发送邮件至doc331@126.com或直接QQ联系客服),我们立即给予删除!

如何预防脊柱手术后静脉血栓.ppt

1、腰椎滑脱术后第腰椎滑脱术后第7 7天天肺栓塞死亡肺栓塞死亡 Total hip replacement,THRTotal knee replacement,TKRHip fractures surgery,HFSSpine S脊柱手术后脊柱手术后脊柱手术后脊柱手术后VTEVTEVTEVTE的风险与预防的风险与预防的风险与预防的风险与预防济南军区总医院 骨病科1.1.脊柱手术后脊柱手术后VTE的发生率是多少?的发生率是多少?2.2.预防措施有那些?是否有效?预防措施有那些?是否有效?3.3.药物预防存在什么风险?药物预防存在什么风险?1.1.Overall rate of VTE after s

2、pinal surgery Overall rate of VTE after spinal surgeryCheng JS,Arnold PM,Anderson PA,et al.Anticoagulation risk in spine surgery.Spine,2010,20;35(9 Suppl):S117-S124.15StudiesOverall rate of DVT is 2.6%(69/2627)DVTOverall rate of PE is 0.69%(18/2627)PEOverall rate of Fatal PE is 0.08%(2/2627)Fatal PE

3、2.2.Mechanical prophylaxisMechanical prophylaxisRokito 329 patients0.3%(1/329)Rokito SE,Schwartz MC,Neuwirth MG.Deep vein thrombosis after major reconstructive spinal surgery.Spine,1996,1(7):853-858.Wood 136 patients1.5%(2/136)Wood KB,Kos PB,Abnet JK,et al.Prevention of deep-vein thrombosis after ma

4、jor spinal surgery:a comparison study of external devices.J Spinal Disord.1997,10(3):209-214.DVT ChemoprophylaxisChemoprophylaxisCheng JS,Arnold PM,Anderson PA,et al.Anticoagulation risk in spine surgery.Spine,2010,20;35(9 Suppl):S117-S124.0.33%(9/2732)0.21%(6/2732)LMWH Cheng JS,Arnold PM,Anderson P

5、A,et al.Anticoagulation risk in spine surgery.Spine,2010,20;35(9 Suppl):S117-S124.3.The risk of 3.The risk of chemoprophylaxischemoprophylaxisLMWH 5.12%(26/508)0.81%(20/2462)0.39%(10/2507)A 56-year-old patient who had underwent a posterior cervical laminectomy and fusion for cervical spondylitic mye

6、lopathy Cheng JS,Arnold PM,Anderson PA,et al.Anticoagulation risk in spine surgery.Spine,2010,20;35(9 Suppl):S117-S124.Mechanical compression devices in the lower extremities are suggested.Initiation of mechanical compression just prior to or at the beginning of surgery and continuation until the pa

7、tient is fully ambulatory is a reasonable practice.Chemoprophylaxis may not be warranted in most common elective spine surgeries.LMWH may be used after surgery after elective combined anterior-posterior spine surgery or in patients identified as having a high risk for VTE,such as multiple trauma,mal

8、ignancy,or hypercoagulable state.For patients with additional risk factors such as advanced age,malignancy,presence of neurologic deficit,previous thromboembolism,or an anterior surgical approach.Any of the following prophylaxis options are recommended:(1)postoperative low dose unfractionated hepari

9、n(LDUH)alone(2)postoperative LMWH alone(3)perioperative intermittent pneumatic compression(IPC)alone.“不为良相,愿为良医不为良相,愿为良医”北宋北宋 范仲淹范仲淹“Either to be a good prime minister or to be an excellent doctor”The Lancet,Volume 376,Issue 9742,Page 657,28 August 2010“病人以性命相托,我们怎能不诚惶诚恐,如临病人以性命相托,我们怎能不诚惶诚恐,如临深渊,如履薄冰深渊,如履薄冰”医学泰斗,湘雅精神缔造者医学泰斗,湘雅精神缔造者张孝骞张孝骞

宁ICP备18001539号-1