Protocol for prophylaxis of venous thromboembolism in varicose vein surgery of the lower limbs

ABSTRACT Pulmonary embolism is the most feared complication of venous thromboembolism (VTE) and the third leading cause of cardiovascular mortality in the world, after acute myocardial infarction and stroke. The risk of VTE is virtually universal in hospitalized patients, especially those with reduced mobility. Although variable in incidence between clinical and surgical patients, up to 66.6% of events related to hospitalizations can occur after discharge, with this risk remaining for up to 90 days. Despite all the investment made in VTE prophylaxis in recent decades, there is still no consensus or specific guidelines for its prevention in patients undergoing conventional surgery for varicose veins of lower limbs. The adoption of a validated risk assessment model for VTE prophylaxis, based on the current literature, may help in the implementation and standardization of VTE prophylaxis in conventional lower limb varicose vein surgery, in addition to this benefit, it may lead to a reduction in the length of hospital stay and the number of readmissions.

摘要：肺栓塞（Pulmonary embolism）是静脉血栓栓塞症（venous thromboembolism, VTE）最凶险的并发症，也是全球范围内仅次于急性心肌梗死与脑卒中的第三大心血管致死病因。住院患者，尤其是活动受限者，其VTE发病风险几乎普遍存在。尽管临床与外科患者的VTE发病率存在差异，但高达66.6%的住院相关血栓事件可发生于出院后，且该风险可持续长达90天。近数十年来，尽管学界在VTE预防领域投入颇丰，但针对接受下肢静脉曲张传统手术的患者，目前仍未形成统一共识或专属预防指南。采用基于当前文献的经验证VTE预防风险评估模型，不仅可助力下肢静脉曲张传统手术中VTE预防工作的实施与标准化，还能缩短患者住院时长、减少再入院次数。