Department of Orthopaedic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
J Surg Oncol. 2010 Sep 1;102(3):276-81. doi: 10.1002/jso.21603.
Deep venous thrombosis (DVT) and pulmonary embolism (PE) are possible sources of morbidity and mortality in patients with musculoskeletal neoplasms (MSN).
To compare the efficacy of aspirin (ASA) and pneumatic compression devices (PCD) to low-molecular-weight heparin (LMWH) and PCD in patients undergoing orthopedic procedures for MSN of the pelvis or lower extremity.
Of 348 patients who met the study criteria, 195 were treated with ASA/PCD and 153 with LMWH/PCD. There were 18 DVT including 8 in ASA/PCD group and 10 in LMWH/PCD group. There were four PEs, all in the LMWH/PCD group.
We found no significant difference in DVT rate between ASA/PCD and LMWH/PCD when used for prophylaxis against thromboembolic complications. Our analysis shows that procedures of the thigh, soft tissue resections, and malignant disease were more often managed with ASA/PCD while joint arthroplasty, procedures of the hip/pelvis, and metastatic disease were more often managed with LMWH/PCD.
DVT prophylaxis in orthopedic oncology remains a complex topic in which physicians must balance the risks of thromboembolic disease against the risks of post-operative complications.
深静脉血栓形成（DVT）和肺栓塞（PE）是骨骼肌肉肿瘤（MSN）患者发生发病率和死亡率的可能原因。
比较骨科手术治疗骨盆或下肢 MSN 患者时，阿司匹林（ASA）和气动压迫装置（PCD）与低分子肝素（LMWH）和 PCD 的疗效。
在符合研究标准的 348 名患者中，195 名接受 ASA/PCD 治疗，153 名接受 LMWH/PCD 治疗。有 18 例 DVT，其中 ASA/PCD 组 8 例，LMWH/PCD 组 10 例。有 4 例 PE，均发生在 LMWH/PCD 组。
我们发现，在预防血栓栓塞并发症方面，ASA/PCD 与 LMWH/PCD 的 DVT 发生率无显著差异。我们的分析表明，大腿手术、软组织切除术和恶性疾病更常采用 ASA/PCD 治疗，而关节置换术、髋/骨盆手术和转移性疾病则更常采用 LMWH/PCD 治疗。
骨科肿瘤学中的 DVT 预防仍然是一个复杂的问题，医生必须权衡血栓栓塞疾病的风险与术后并发症的风险。
