美国儿科外科协会成果和循证实践委员会进行了一项系统回顾，以描述儿科外科和创伤患者中静脉血栓栓塞 (VTE) 的流行病学，并制定筛查和预防建议。Medline (Ovid)、Embase、Cochrane、和 Web of Science 数据库的查询时间为 2000 年 1 月至 2021 年 12 月。搜索词涉及以下主题：发病率、超声筛查以及机械和药物预防。遵循系统评价和荟萃分析 (PRISMA) 指南的首选报告项目。共识建议是根据现有的最佳文献得出的。纳入了一百二十四项研究。儿科手术人群中 VTE 的发生率为 0.29%（范围 = 0.1%-0.48%），与手术类型、输血、长时间麻醉、恶性肿瘤、先天性心脏病、炎症性肠病、感染和女性直接相关。儿童创伤人群中 VTE 的发生率为 0.25%（范围 = 0.1%-0.8%），与损伤严重程度、大手术、中心静脉置管、体重指数、脊髓损伤和住院时间直接相关。不建议对 VTE 进行常规超声筛查。当有合适尺寸的设备可用时，考虑对高危不能活动的儿科手术患者使用顺序加压设备。对于损伤严重程度评分 >25 的 >15 岁青少年和 <15 岁青春期后儿童，考虑单独使用机械预防或联合药物预防。当采用药物预防时，低分子量肝素优于普通肝素。虽然 VTE 在儿童中仍然是一种罕见的并发症，但在某些人群中考虑机械和药物预防是适当的。2-4 级研究的系统回顾。3-4 级。版权所有 © 2024。由爱思唯尔公司出版。

The American Pediatric Surgical Association Outcomes and Evidence-Based Practice Committee conducted a systematic review to describe the epidemiology of venous thromboembolism (VTE) in pediatric surgical and trauma patients and develop recommendations for screening and prophylaxis.The Medline (Ovid), Embase, Cochrane, and Web of Science databases were queried from January 2000 through December 2021. Search terms addressed the following topics: incidence, ultrasound screening, and mechanical and pharmacologic prophylaxis. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were followed. Consensus recommendations were derived based on the best available literature.One hundred twenty-four studies were included. The incidence of VTE in pediatric surgical populations is 0.29% (Range = 0.1%-0.48%) and directly correlates with surgery type, transfusion, prolonged anesthesia, malignancy, congenital heart disease, inflammatory bowel disease, infection, and female sex. The incidence of VTE in pediatric trauma populations is 0.25% (Range = 0.1%-0.8%) and directly correlates with injury severity, major surgery, central line placement, body mass index, spinal cord injury, and length-of-stay. Routine ultrasound screening for VTE is not recommended. Consider sequential compression devices in at-risk nonmobile, pediatric surgical patients when an appropriate sized device is available. Consider mechanical prophylaxis alone or with pharmacologic prophylaxis in adolescents >15 y and post-pubertal children <15 y with injury severity scores >25. When utilizing pharmacologic prophylaxis, low molecular weight heparin is superior to unfractionated heparin.While VTE remains an infrequent complication in children, consideration of mechanical and pharmacologic prophylaxis is appropriate in certain populations.Systematic Review of level 2-4 studies.Level 3-4.Copyright © 2024. Published by Elsevier Inc.