Milbrink J, Bergqvist D
Department of Orthopaedics, University Hospital, Uppsala, Sweden.
Vasa. 2008 Nov;37(4):353-7. doi: 10.1024/0301-1526.37.4.353.
Few studies have shown the effect of thromboprophylactic regimen with low molecular weight heparin (LMWH) on the incidence of clinical venous thromboembolism (VTE) in common practice. The aim was to study the three-year incidence of clinically overt VTE events at a university based orthopaedic department with some 3300 operations performed and 15 000 patients treated annually.
Since all Swedish citizens have an individual identification number it was possible tp follow up all patients operated during a 3 year period (2000-2002) for a period of four months.
The incidence of VTE in the classical high-risk groups of hip fracture surgery, total hip arthroplasty (THA) and total knee arthroplasty (TKA) was low - about 0.6 %, while the Pulmonary embolism (PE) incidence in the hip fracture group was 0.27%, with two cases of fatal PE occurring 72 and 109 days after surgery. Patients with ankle fractures had more VTE. The majority of clinical VTE occurred after discharge from hospital.
When using routine thrombopropylaxis with LMWH in orthopaedic surgery the rate of symptomatic VTE is low.
很少有研究表明在常规医疗中低分子量肝素（LMWH）血栓预防方案对临床静脉血栓栓塞症（VTE）发生率的影响。目的是研究一所大学骨科每年进行约3300例手术、治疗15000名患者时，临床明显VTE事件的三年发生率。
由于所有瑞典公民都有个人身份识别号码，因此有可能对3年期间（2000 - 2002年）接受手术的所有患者进行为期4个月的随访。
髋部骨折手术、全髋关节置换术（THA）和全膝关节置换术（TKA）等典型高危组的VTE发生率较低，约为0.6%，而髋部骨折组的肺栓塞（PE）发生率为0.27%，有2例致命性PE分别在术后72天和109天发生。踝关节骨折患者发生VTE的情况更多。大多数临床VTE发生在出院后。
在骨科手术中使用LMWH进行常规血栓预防时，有症状VTE的发生率较低。
