背景:目前国内外对于脊柱手术术后患者下肢深静脉血栓的发病率存在较大的分歧,对于脊柱手术后深静脉血栓的预防尚未形成统一的看法.目的:分析脊柱术后深静脉血栓预防的进展.方法:从中国知网以及PubMed数据库搜索并经过筛选的1993年1月至2016年1月与脊柱术后深静脉血栓预防相关的41篇文献,对其当前的预防方法、预防措施以及危险因素、发病率等方面进行总结.结果与结论:①随着手术技术的提高及医疗器械的发展,许多新技术、新器械及生物材料被广泛地应用于脊柱外科,同时复杂性、困难性手术的增加、手术创伤的加大及手术时间的延长,脊柱术后下肢深静脉血栓形成的风险也逐年增加,发病率呈现上升的趋势;②脊柱术后深静脉血栓的预防手段与方式在不断丰富,目前分级预防方式较为成熟有效;③医护人员行静脉穿刺或注射应尽量选择上肢建立静脉通道,避免下肢静脉血管的损伤;④未来的研究应进一步明确脊柱手术后患者深静脉血栓形成的流行病学特点,相关干预的时机与时限,以及有效的药物及物理干预方法.%BACKGROUND: The incidence of deep venous thrombosis of the lower extremity after spinal surgery remains controversial, and its prevention is still under discussion.OBJECTIVE: To summarize the progress of the prevention of the deep venous thrombosis after spinal surgery.METHODS: The domestic and foreign related literature about the deep vein thrombosis after the spinal surgery, which was filtrated from CNKI and PubMed databases, were searched for the articles concerning the prevention of the deep venous thrombosis after spinal surgery published from January 1993 to January 2016.Finally, 41 eligible articles were included, and the prevention methods, risk factors and incidence were summarized.RESULTS AND CONCLUSION: (1) With the technology and medical equipment development, more novel technologies and biomaterials are extensively applied in spinal surgery; meanwhile, complex and difficult surgeries,big surgical trauma and prolonged operation time all increase the risk of deep venous thrombosis of the lower extremity;thereafter, the incidence is on a rise. (2) The prevention methods of deep venous thrombosis have been improved, and the grading of prevention becomes more sufficient. (3) During venipuncture and injection, upper extremity should be selected firstly, so as to avoid damage to the lower extremity veins. (4) The following studies should concentrate on understanding the epidemic characteristics of deep venous thrombosis of the lower extremity after spinal surgery, and confirming the best prevention time, as well as effective drugs and physical measurements.
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