全髋关节置换术后下肢深静脉血栓形成的预防护理进展
Progress in Preventive Nursing of Lower Extremity Deep Vein Thrombosis after Total Hip Arthroplasty
摘要: 全髋关节置换术(THA)是终末期髋关节疾病首选根治方案，但术后下肢深静脉血栓(DVT)及继发肺栓塞(PE)是术后可致死的首要可预防并发症，严重延长住院周期、加重医疗负担。目前静脉血栓栓塞症(VTE)预防已从统一标准化干预转向个体化精准防控。护理工作贯穿围术期血栓预防全流程，是风险筛查、干预实施、延续管理的核心载体。本文系统综述THA术后DVT流行病学特征、多维度危险因素，对比阿司匹林、低分子肝素、新型口服抗凝药等化学预防方案的循证疗效与安全风险，阐述间歇充气加压、早期功能锻炼等机械预防协同价值，分析Caprini风险分层、ERAS快速康复适配策略、特殊复杂人群血栓防控难点，梳理围术期标准化护理、多学科协作、出院延续护理等前沿实践进展，为骨科临床血栓预防护理规范化实施提供循证理论支撑。
Abstract: Total hip arthroplasty (THA) is the preferred curative treatment for end-stage hip joint diseases; however, postoperative deep vein thrombosis (DVT) and secondary pulmonary embolism (PE) remain the leading preventable complications with fatal outcomes, significantly prolonging hospital stays and increasing healthcare burdens. Currently, venous thromboembolism (VTE) prevention has shifted from standardized interventions to personalized, precision-based strategies. Nursing care spans the entire perioperative thrombosis prevention process and serves as the core framework for risk screening, intervention implementation, and ongoing management. This review systematically examines the epidemiological characteristics and multidimensional risk factors of post-THA DVT, compares the evidence-based efficacy and safety profiles of chemical prophylaxis regimens such as aspirin, low molecular weight heparin, and novel oral anticoagulants, elucidates the synergistic value of mechanical prevention measures including intermittent pneumatic compression and early functional exercise, analyzes challenges in thrombosis prevention for high-risk populations using the Caprini risk stratification system and ERAS rapid recovery adaptation strategies, and summarizes advancements in standardized perioperative nursing care, multidisciplinary collaboration, and discharge follow-up care, thereby providing evidence-based theoretical support for the standardized implementation of thrombosis prevention nursing in orthopedic practice.
文章引用：杨翠萍, 艾绍花. 全髋关节置换术后下肢深静脉血栓形成的预防护理进展[J]. 临床医学进展, 2026, 16(8): 1700-1711. https://doi.org/10.12677/acm.2026.1682952

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