Dorfman G S, Froehlich J A
Brown University School of Medicine, Providence, RI.
Semin Arthroplasty. 1992 Apr;3(2):72-83.
Lower-extremity venous thrombosis and its major complication, pulmonary embolism, occur with an increased prevalence in the orthopedic population, even in patients receiving prophylactic therapy. Compression ultrasound has become the diagnostic test of choice to screen high-risk patients and to evaluate symptomatic patients. Contrast venography should be reserved to evaluate the few patients in whom adequate quality ultrasound examinations are unobtainable. Pulmonary angiography remains the "gold standard" in the diagnosis of pulmonary embolism and should be obtained in all patients in whom ventilation-perfusion scan results are discordant with clinical suspicion, and whenever treatment risks are extraordinary.
下肢静脉血栓形成及其主要并发症肺栓塞在骨科人群中的发生率有所增加，即使是接受预防性治疗的患者也是如此。超声压迫检查已成为筛查高危患者和评估有症状患者的首选诊断方法。对于少数无法获得高质量超声检查结果的患者，应采用静脉造影进行评估。肺血管造影仍然是诊断肺栓塞的“金标准”，对于所有通气-灌注扫描结果与临床怀疑不符的患者，以及治疗风险极高的患者，均应进行肺血管造影检查。
