全膝关节置换术后静脉血栓栓塞的预防研究

静脉血栓栓塞症（VTE）是全膝关节置换术后发生和死亡的主要原因。研究显示，术后发生静脉血栓栓塞症可延长住院时间。在过去15年中，尽管临床上采用了全面的静脉血栓栓塞预防方案，但全膝关节置换术后出现肺栓塞的发生率基本保持不变，约为0.4%。目前VTE预防方案包括早期下地行走、患者评估和药物治疗等。对于具有静脉血栓栓塞症风险的患者，阿司匹林应用越来越广泛。最新研究证实，阿司匹林具有相对较低的出血风险和低成本效益。也有研究认为，新型口服抗凝剂、华法林、低分子肝素，包括Xa因子和直接凝血酶抑制剂均对降低术后VTE有效，但可能与出血和伤口并发症发生率的增加有关。本文主要综述近年来VTE预防的研究进展，旨在为临床医生提供用药指导。

Prevention of Venous Thromboembolism after Total Knee Arthroplasty

Venous thromboembolism (VTE) is the leading cause of death and death after total knee arthroplasty. Studies have shown that postoperative VTE can prolong hospital stay. In the past 15 years, despite the clinical use of a comprehensive VTE prevention program, the incidence of pulmonary embolism after total knee arthroplasty remained essentially unchanged (approximately 0.4%). Current VTE prevention programs include early ground walking, patient assessment, and medication. Aspirin is increasingly used in patients at risk for venous thromboembolism. Recent research confirms that aspirin has a relatively low risk of bleeding and low cost benefits. Studies have also suggested that new oral anticoagulants, warfarin, low molecular weight heparin, including factor Xa and direct thrombin inhibitors, are effective in reducing postoperative VTE, but may be associated with increased rates of bleeding and wound complications. This article mainly reviews the recent research on mechanical compression devices and drug VTE prevention, aiming to provide reference for clinical.