Application research of evidence-based deep vein thrombosis prevention and control protocols in hepatobiliary and pancreatic surgery
基于循证的深静脉血栓防控方案在肝胆胰外科的应用研究

摘要

深静脉血栓（deep venous thrombosis, DVT）是肝胆胰外科患者围手术期常见的严重并发症，其发生率显著高于其他腹部外科亚专科。肝胆胰手术的复杂性、患者多合并恶性肿瘤或基础疾病等因素，导致血液高凝状态、静脉血流缓慢及血管内皮损伤的风险显著增加，若未及时干预，可能引发肺栓塞等致命后果，或导致血栓后综合征，严重影响患者生活质量。循证护理以最新、最可靠的临床证据为基础，结合护理实践经验与患者个体需求，为 DVT 防控提供科学规范的解决方案。本文系统梳理肝胆胰外科 DVT 的危险因素与循证防控依据，综述基础预防、物理预防、药物预防及多学科协同防控等方案的临床应用现状，分析当前实践中存在的问题，并展望未来发展趋势，旨在为临床护理实践提供参考，进一步提升肝胆胰外科 DVT 防控的科学性与有效性。

Abstract

Deep venous thrombosis (DVT) is a common and serious complication in patients undergoing hepatobiliary and pancreatic surgery during the perioperative period, and its incidence is significantly higher than that of other subspecialties of abdominal surgery. The complexity of hepatobiliary and pancreatic surgeries, as well as the fact that many patients have concurrent malignant tumors or underlying diseases, significantly increase the risk of hypercoagulable state of the blood, slow venous blood flow and vascular endothelial injury. If not intervened in time, it may lead to fatal consequences such as pulmonary embolism or cause post-thrombotic syndrome, seriously affecting the quality of life of patients. Evidence-based nursing, based on the latest and most reliable clinical evidence, combines practical nursing experience with individual patient needs to provide scientific and standardized solutions for the prevention and control of DVT. This article systematically reviews the risk factors and evidence-based prevention and control basis of DVT in hepatobiliary and pancreatic surgery, summarizes the current clinical application status of basic prevention, physical prevention, drug prevention and multidisciplinary collaborative prevention and control plans, analyzes the existing problems in current practice, and looks forward to future development trends, aiming to provide references for clinical nursing practice. Further enhance the scientificity and effectiveness of DVT prevention and control in hepatobiliary and pancreatic surgery.