| 标题： | 老年髋部骨折患者下肢深静脉血栓围手术期基础预防措施专家共识（2024版） |
| title： | Expert Consensus on Basic Preventive Measures for Deep Venous Thrombosis in Elderly Patients with Hip Fractures Around the Time of Surgery (2024) |
| 版本： | 原创版 |
| version： | Original |
| 分类： | 专家共识 |
| classification： | Experts consensus |
| 领域： | 预防 |
| field： | Prevention |
| 国家和地区： | 中国 |
| Country and region： | China |
| 指南使用者： | 本共识使用人群为骨科医护人员及相关其他临床实践工作者。 |
| Guide users： | The user population of this consensus is orthopedic medical staff and related other clinical practitioners. |
| 证据分级方法： | 本共识的证据水平根据牛津大学循证医学中心（OCEBM）制定的证据等级标准，结合相关研究的类型和质量，将证据质量等级分为1a、1b、1c、2a、2b、2c、3a、3b、4、5级。依据文献证据等级标准确定推荐强度。进一步根据德尔菲法，专家组对每个共识证据进行反复评估，给出“赞同” “反对” “不确定”的反馈意见，经过多轮讨论，根据赞同率得出专家共识度，最终形成统一的共识意见。 |
| Evidence grading method： | The level of evidence for this consensus was graded according to the Oxford Centre for Evidence-Based Medicine (OCEBM) criteria, which were further categorized into grades 1a, 1b, 1c, 2a, 2b, 2c, 3a, 3b, 4, and 5 based on the type and quality of the relevant research. The strength of recommendation was determined based on the level of evidence. Using the Delphi technique, the expert panel repeatedly assessed each piece of evidence in the consensus, providing feedback in the form of "agree," "disagree," or "uncertain." After multiple rounds of discussion, the level of expert consensus was determined based on the rate of agreement, ultimately resulting in a unified consensus statement. |
| 制定单位： | 宁波市第六医院；深圳市第二人民医院；河北医科大学第三医院；中国人民解放军总医院第一医学中心 |
| Formulating unit： | Ningbo NO.6 Hospital；Shenzhen Second People's Hospital；The Third Hospital of Hebei Medical University；The First Medical Center of PLA General Hospital |
| 注册时间： | 2024-06-13 |
| Registration time： | |
| 注册编号： | PREPARE-2024CN816 |
| Registration number： | |
| 指南制订的目的： | 随着人口老龄化进程加快，老年髋部骨折的发病率不断上升，由于老年人身体器官功能退化，合并多种基础疾病，具有高并发症、高致残率、高死亡率的特点，已成为威胁老年人健康的公共问题。老年髋部骨折患者围手术期发生下肢深静脉血栓的发生率极高，一旦发生肺栓塞将显著增加患者死亡风险。鉴于此，各项指南和共识均强调对此类患者应积极采取基础预防、物理预防、药物预防的全面预防措施。此预防措施体系中，基础预防是物理预防、药物预防的基础；在物理预防、药物预防措施禁忌的情况下基础预防具有非常重要的作用，与物理预防和化学预防措施具有同等重要的效果。在临床上基础预防措施尚缺乏明确统一的推荐意见。为此，中华护理学会骨科护理专业委员会、中国医疗保健国际交流促进会骨科分会和《中华创伤杂志》编辑委员会组织相关专家，结合循证医学证据和专家临床经验制订《老年髋部骨折患者下肢深静脉血栓围手术期基础预防措施专家共识（2024版）》，从体位管理、肢体运动、早期下床活动、营养管理、体温保护、中医适宜技术、健康教育等方面提出10条推荐意见，以规范老年髋部骨折患者围手术期基础预防措施，为骨科医护人员及相关其他临床实践工作者提供指导性意见。 |
| Purpose of the guideline： | With the acceleration of the aging process of the population,the incidence of hip fracture in the elderly is rising,due to the deterioration of the body organ function of the elderly,combined with a variety of underlying diseases,with the characteristics of high complications,high disability rate and high mortality,it has become a public problem that threatens the health of the elderly.Elderly patients with hip fracture have a very high incidence of perioperative lower extremity deep vein thrombosis,and pulmonary embolism will significantly increase the risk of death.In view of this,various guidelines and consensus emphasize that comprehensive preventive measures including basic prevention,physical prevention,and drug prevention should be actively taken for such patients.In this preventive system,basic prevention is the basis of physical prevention and drug prevention;Basic prophylaxis plays a very important role in the case of contraindications to physical and pharmacological prophylaxis,and has the same important effect as physical and chemical prophylaxis.There is a lack of clear and consistent recommendations for basic preventive measures in clinical practice.To this end,the Orthopedic Nursing Professional Committee of the Chinese Nursing Association,the Orthopaedic Branch of the China Association for the Promotion of International Exchange in Health Care and the Editorial Board of the Chinese Journal of Trauma organized relevant experts to formulate the Expert Consensus on Basic Perioperative Preventive Measures for Deep Vein Thrombosis of the Lower Extremities in Elderly Patients with Hip Fracture(2024) based on evidence-based medical evidence and expert clinical experience,and put forward 10 recommendations from the aspects of position management,limb movement,early getting out of bed,nutrition management,body temperature protection,appropriate techniques of traditional Chinese medicine,and health education.In order to standardize the perioperative basic preventive measures for elderly patients with hip fracture,and to provide guiding opinions for orthopedic medical staff and related clinical practitioners. |
