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胃肠恶性肿瘤患者围手术期血栓管理的现状和展望

Current status and prospect of perioperative thrombus management in gastrointestinal cancer

摘要:

近年来,随着外科理念、手术技术和医疗器械的不断进步,胃肠外科围手术期并发症发生率和病死率已获得显著改善,但胃肠恶性肿瘤患者围手术期静脉血栓管理仍不乐观,在国家政策、医院管理和医师教育等各个方面,都存在不足和需要改进之处.随着老龄化程度日趋严重及心血管疾病的发病率逐年升高,临床上会遇到越来越多正在接受抗栓治疗但需要择期或紧急手术的患者.对于此类患者围手术期如何平衡出血和血栓风险,如何保障患者围手术期安全,也是临床外科医师经常遇到的难题.我国胃肠外科围手术期血栓风险管理任重道远,只有广大同仁重视并采取措施,才能切实降低外科手术患者血栓相关并发症的发生.

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abstracts:

Thanks to the progress of surgical theory and skills,as well as the application of modern medical devices in general surgery,both the occurrence of perioperative complications and mortality of gastrointestinal surgery have significantly reduced recently.However,it is still far from optimal in terms of the perioperative venous thromboembolism (VTE) management in gastrointestinal cancer,and what is responsible for that? This paper aims at finding out the reasons contributing to the current status,giving suggestions for how to make improvement at both disease level and hospital management level.At the same time,while paying attention for the prophylaxis of VTE,there have been more and more patients receiving antithrombotic treatment require elective or emergent surgery in clinical practice,due to aging and increased incidence of cardiovascular disease year by year.How to balance the bleeding and thrombosis risk for these patients during perioperative periods is also a question we are going to discuss.In conclusion,as to the issue of the management of perioperative thrombosis,there will be a long way for Chinese doctors to go.Our peers should pay more attention to this problem and take more efforts,so that the thrombotic complications in surgical patients can be reduced.

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