Prevention and treatment of deep vein thrombosis during perioperative period in patients with abdominal wall hernia
10.3760/cma.j.issn.1673-9752.2018.11.005
- VernacularTitle:腹壁疝患者围术期深静脉血栓形成的预防和治疗
- Author:
Ziwen LIU
1
;
Guangyong ZHANG
;
Hangyu LI
;
Yingmo SHEN
;
Chaoyang LU
Author Information
1. 100730,中国医学科学院北京协和医学院北京协和医院基本外科
- Keywords:
Abdominal wall hernia;
Deep vein thrombosis;
Hernia repair;
Laparoscopy;
Perioperative period;
Prevention;
Treatment;
Anticoagulation;
Thrombolysis
- From:Chinese Journal of Digestive Surgery
2018;17(11):1083-1086
- CountryChina
- Language:Chinese
-
Abstract:
Deep vein thrombosis (DVT) refers to a venous reflux disorder caused by abnormal condensation of blood in deep veins,It is detected in cardinal veins of the whole body and often occurred in the lower extremities.Desquamation of thrombus may cause pulmonary embolism (PE).PE and DVT are two clinical manifestations of different stages of the same disease,which are collectively referred to as venous thromboembolism (VTE).Five famous experts in hernia and abdominal wall surgery explored the prevention and treatment of DVT during perioperative period in patients undergoing abdominal wall hernia surgery from different angles based on clinical experiences.Professor Liu Ziwen introduced the epidemiology of DVT during perioperative period in patients undergoing abdominal wall hernia surgery,emphasized its risks,analyzed systematically its mechanisms including slow venous blood flow,vein injury,high blood coagulation state,underlying diseases and specific factors of abdominal wall hernia surgery,focused on mechanisms of inflammation caused by meshes inducing DVT.Professor Zhang Guangyong introduced informatively its diagnosis with clear and careful thinking,from the clinical manifestations to assistant examinations and moreover to Wells quantitative scoring,from general to specific and from qualitative to quantitative,striving to achieve early and precise diagnosis in order to prevent misseddiagnosis or ignoration of its danger level.Professor Li Hangyu emphasized appropriate preventive and treatment measures according to different stages and risk levels by evaluating the risk factors of preoperative,intraoperative and postoperative DVT.Professor Shen Yingmo analyzed special factors of laparoscopic abdominal wall hernia inducing DVT during the perioperative period,and indicated that surgeons should select surgical methods individually after comprehensive evaluation and consideration because of uncertainty of risk degree in laparoscopic and open surgery inducing DVT during perioperative period based on exis-ting evidence-based medicine and related guidelines.Professor Lu Chaoyang introduced three categories of main treatments including anticoagulation therapy,thrombolytic therapy and surgical therapy,and specific drugs,indications,advantages and disadvantages,opportunities,recommended clinicians to select individually and rationally.
