Bloomfield Michael R, Patterson Ryan W, Froimson Mark I
Orthopaedic and Rheumatology Institute, Cleveland Clinic, Ohio, USA.
Am J Orthop (Belle Mead NJ). 2011 Aug;40(8):E148-51.
In the study reported here, we analyzed the complications associated with anticoagulation in total joint arthroplasty patients treated for venous thromboembolism (VTE) in the early postoperative period. Twenty-nine consecutive cases from a 1-year period were identified and retrospectively reviewed. VTE treatment, which in most instances (79%) consisted of a heparin drip, was begun a mean of 2.3 days after surgery. Patients received a mean (SD) of 4.4 (5.0) units of packed red blood cells. There were no differences in bleeding parameters with respect to timing of initiation of anticoagulation. Local and systemic bleeding complications were common. The proportion of patients who were transfused was significantly (P<.0001) higher for VTE patients than for control patients, and transfused VTE patients received significantly (P = .0004) more blood products. In total joint arthroplasty patients, VTE treatment began 2.3 days after surgery and had a high incidence of complications related to bleeding.
在本报告的研究中，我们分析了全关节置换术患者术后早期治疗静脉血栓栓塞（VTE）时抗凝相关的并发症。确定了来自1年期间的29例连续病例并进行回顾性分析。VTE治疗在大多数情况下（79%）采用肝素滴注，平均在术后2.3天开始。患者平均接受了4.4（5.0）单位的浓缩红细胞。抗凝开始时间的出血参数无差异。局部和全身出血并发症很常见。VTE患者输血比例显著高于对照组（P<0.0001），且接受输血的VTE患者接受的血液制品显著更多（P = 0.0004）。在全关节置换术患者中，VTE治疗在术后2.3天开始，且出血相关并发症发生率较高。
