普通外科围手术期肺栓塞预防与管理OA

Pulmonary embolism during the perioperative period of general surgery elevates mortality risk.Individual and treatment-related factors,underlying diseases,and the awareness of surgeons to bleeding and thromboembolism risk evaluation may influence the diagnostic assessment,prevention,and treatment strategy of pulmonary embolism.The symptoms,signs,D-dimer levels,electrocardiogram,and ultrasound findings of pulmonary embolism lack specificity.Computed tomography pulmonary angiography(CTPA)may not be feasible in the patients with severe hemodynamic instability,thereby affecting diagnostic accuracy.Therefore,it is essential to optimize the diagnostic protocol,appropriately determine the timing of anticoagulation and reperfusion therapy,and standardize the perioperative management of anticoagulant medications,including discontinuation,bridging,and resumption.Furthermore,indications for interventional treatments such as catheter-directed thrombolysis and inferior vena cava filter placement should be strictly limited.