搜索血栓形成何时会发生
小血栓，大威胁
血栓栓塞性疾病在全世界都是发病和死亡的主要原因之一。静脉血栓栓塞症 (VTE)－包括深静脉血栓形成(DVT) 和肺动脉栓塞 (PE)，是继缺血性心脏病和脑卒中之后处于第三位的最常见的心血管疾病，据估计，约10％的医院死亡与VTE相关。6, 37
相比于发生DVT后再进行治疗，对高风险患者采取血栓预防措施是降低这些并发症发生风险的最佳方法。6
止血
正常血液凝固：维持生命最基本的生理过程
止血－血管受损后防止大量血液流失的正常生理反应。33
血管受损后可引起以下一连贯的反应：
止血异常或过度凝血
正常的止血功能对维持生命固然是必不可少的，但如果病理性地形成血凝块，或血栓，就会带来重大的健康风险。VTE是骨科大手术（如择期髋关节或膝关节置换术）后最常见和严重的并发症之一。6
众多因素都可能增加患者发生VTE的风险
VTE与肿瘤、创伤和手术有一定的关系。在有些病例中，VTE的发生存在先天危险因素，患者没有任何明确诱发因素（也就是，没有触发事件）。14
- 6 - Geerts WH, Bergqvist D, Pineo GF, et al. Prevention of venous thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008;133(6 suppl):381S-453S.
- 37 - Sandler DA. Martin JF. Autopsy proven pulmonary embolism in hospital patients: are we detecting enough deep vein thrombosis? J R Soc Med. 1989;82(4):203-205.
- 38 - Schulman S, Lindmarker P, Holmström M, et al. Post-thrombotic syndrome, recurrence, and death 10 years after the first episode of venous thromboembolism treated with warfarin for 6 weeks or 6 months. J Thromb Haemost. 2006;4(4):734-742.
- 39 - Pengo V, Lensing AW, Prins MH, et al; Thromboembolic Pulmonary Hypertension Study Group. Incidence of chronic thromboembolic pulmonary hypertension after pulmonary embolism. N Engl J Med. 2004;350(22):2257-2264.
- 33 - Colman RW, Clowes AW, George JN, Goldhaber SZ, Marder VJ. Overview of hemostasis. In: Colman RW, Clowes AW, George JN, Goldhaber SZ, Marder VJ, eds. Hemostasis and Thrombosis: Basic Principles and Clinical Practice. 5th ed. Philadelphia, PA: Lippincott, Williams & Wilkins; 2006:1-16.
- 40 - Adams GL, Manson RJ, Turner I, Sindram D, Lawson JH. The balance of thrombosis and hemorrhage in surgery. Hematol Oncol Clin North Am. 2007;21(1):13-24.
- 41 - Heit JA. Venous thromboembolism: disease burden, outcomes and risk factors. J Thromb Haemost. 2005;3(8):1611-1617.
- 35 - Fuster V, Moreno PR, Fayad ZA, Corti R, Badimon JJ. Atherothrombosis and high-risk plaque: part I: evolving concepts. J Am Coll Cardiol. 2005;46(6):937-954.
- 42 - Waldo AL. Anticoagulation: stroke prevention in patients with atrial fibrillation. Med Clin North Am. 2008;92(1):143-159.
- 43 - Merli GJ. Pathophysiology of venous thrombosis, thrombophilia, and the diagnosis of deep vein thrombosis-pulmonary embolism in the elderly. Clin Geriatr Med. 2006;22(1):75-92.
- 14 - Turpie AG, Chin BS, Lip GY. Venous thromboembolism: pathophysiology, clinical features, and prevention. BMJ. 2002;325(7369):887-890.
- 44 - Kakkar AK. Prevention of venous thromboembolism in general surgery. In: Colman RW, Clowes AW, George JN, Goldhaber SZ, Marder VJ, eds. Hemostasis and Thrombosis: Basic Principles and Clinical Practice. 5th ed. Philadelphia, PA: Lippincott, Williams & Wilkins; 2006:1361-1367.
- 45 - Motte S, Samama CM, Guay J, Barré J, Borg JY, Rosencher N. Prevention of postoperative venous thromboembolism. Risk assessment and methods of prophylaxis. Can J Anaesth. 2006;53(6 suppl):S68-S79.
