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髋关节镜检查后静脉血栓栓塞性疾病的发病率

Incidence of venous thromboembolic disease following hip arthroscopy.

作者信息

Salvo John P, Troxell Corey R, Duggan Daniel P

机构信息

Cooper Bone and Joint Institute, Cooper University Hospital, Voorhees, NJ 08043, USA.

出版信息

Orthopedics. 2010 Sep 7;33(9):664. doi: 10.3928/01477447-20100722-10.

Abstract

Venous thromboembolic disease is a known complication of orthopedic surgery. Hip arthroscopy is a technically demanding procedure with a significant learning curve and low reported complication rate. Few reports document the incidence of venous thromboembolic disease following hip arthroscopy. Our hypothesis was that the incidence of venous thromboembolic disease following hip arthroscopy was comparable to that reported for knee arthroscopy. Eighty-one consecutive patients undergoing hip arthroscopy were retrospectively reviewed. All patients underwent standard diagnostic hip arthroscopy under traction of the operative leg against a well-padded perineal post. All procedures were performed on an outpatient basis. Three of 81 patients (3.7%) developed a clinically symptomatic venous thromboembolic disease in the postoperative period. The diagnosis was suspected clinically and confirmed with the use of a Doppler ultrasound. No patient developed symptomatic pulmonary emboli. One patient used oral contraceptives and 2 had no known risk factors for venous thromboembolic disease. All patients were successfully treated with anticoagulation. This is the first study to document multiple occurrences of venous thromboembolic disease following hip arthroscopy. This study demonstrated the incidence of symptomatic venous thromboembolic disease after hip arthroscopy to be 3.7%. Further study investigation is warranted regarding the incidence of symptomatic and asymptomatic venous thromboembolic disease following hip arthroscopy.

摘要

静脉血栓栓塞性疾病是骨科手术已知的并发症。髋关节镜检查是一项技术要求较高的手术,有显著的学习曲线且报告的并发症发生率较低。很少有报告记录髋关节镜检查后静脉血栓栓塞性疾病的发生率。我们的假设是,髋关节镜检查后静脉血栓栓塞性疾病的发生率与膝关节镜检查报告的发生率相当。对连续81例行髋关节镜检查的患者进行了回顾性研究。所有患者均在手术侧下肢靠在加垫良好的会阴柱上牵引的情况下接受标准诊断性髋关节镜检查。所有手术均在门诊进行。81例患者中有3例(3.7%)在术后出现临床症状性静脉血栓栓塞性疾病。临床怀疑诊断并通过多普勒超声确诊。没有患者发生有症状的肺栓塞。1例患者使用口服避孕药,2例无已知的静脉血栓栓塞性疾病危险因素。所有患者均通过抗凝治疗成功治愈。这是第一项记录髋关节镜检查后多次发生静脉血栓栓塞性疾病的研究。本研究表明,髋关节镜检查后有症状的静脉血栓栓塞性疾病的发生率为3.7%。有必要对髋关节镜检查后有症状和无症状的静脉血栓栓塞性疾病的发生率进行进一步的研究调查。

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