The Prince Charles Hospital Orthopaedic, Research and Audit Unit, The Prince Charles Hospital, Brisbane, Queensland, Australia.
J Arthroplasty. 2013 Jan;28(1):187-92. doi: 10.1016/j.arth.2012.06.001.
Bleeding-related wound complications cause significant morbidity in lower limb arthroplasty surgery. Patients who require therapeutic anticoagulation in the perioperative period are potentially at higher risk for these complications. This is a retrospective case-control study reviewing all primary total hip arthroplasties performed in a single center during a 5-year period and comparing outcomes of the patients on warfarin with a double-matched control group of patients not on warfarin. The warfarin group had a significantly higher risk of deep joint infection (9% vs 2.2%), hematoma/wound ooze (28% vs 4%), and superficial infection (13.5% vs 2.2%). Managing patients undergoing total hip arthroplasty with therapeutic anticoagulation is a balance between the risk of thromboembolic disease and bleeding-related complications. Improved understanding of this risk will better allow patients to make an informed decision regarding their elective arthroplasty surgery.
出血相关的伤口并发症在下肢关节置换手术中会导致较高的发病率。围手术期需要进行抗凝治疗的患者发生这些并发症的风险可能更高。这是一项回顾性病例对照研究，对 5 年内在单一中心进行的所有初次全髋关节置换术进行了回顾，并比较了华法林治疗组与未使用华法林的双匹配对照组患者的结果。华法林组的深部关节感染风险明显更高（9% vs. 2.2%），血肿/伤口渗液（28% vs. 4%）和浅表感染（13.5% vs. 2.2%）。对于接受抗凝治疗的全髋关节置换术患者，血栓栓塞性疾病和出血相关并发症的风险之间需要取得平衡。更好地了解这种风险将使患者能够就其择期关节置换手术做出知情决策。
