Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Japan.
Department of Orthopaedic Surgery, Tohoku Rosai Hospital, Sendai, Japan.
J Shoulder Elbow Surg. 2014 May;23(5):605-12. doi: 10.1016/j.jse.2014.01.054.
The purpose of this study was to investigate the incidence of venous thromboembolism (VTE) after elective arthroscopic shoulder surgery.
One hundred seventy-five consecutive patients who underwent arthroscopic shoulder surgery were enrolled (mean age, 61 years). Patients who had VTE preoperatively and underwent trauma surgery or arthroplasty were excluded. All the patients used foot pumps or elastic stockings after surgery for deep venous thrombosis (DVT) prophylaxis. DVT in the 4 limbs was assessed by ultrasound before and after surgery. Pulmonary embolism was diagnosed by computed tomography pulmonary angiography. Risk factors related to DVT were assessed.
The overall incidence of DVT was 10 of 175 patients (5.7%). Most of the DVT cases were detected at 1 to 2 days after surgery. All patients were asymptomatic. There were no patients who had symptomatic pulmonary embolism. However, an asymptomatic pulmonary embolus developed in 1 patient during the 3-month follow-up period. There were no significant differences between the DVT and non-DVT groups regarding the risk factors.
Our data have shown that symptomatic VTE is rare after elective arthroscopic shoulder surgery. However, asymptomatic VTE may occur even with DVT preventive measures. Because most of the DVTs were found in the calf veins, we recommend that surgeons pay attention to the possibility of DVT in the lower extremities even after arthroscopic shoulder surgery. The incidence of asymptomatic VTE after elective arthroscopic shoulder surgery was 5.7%. All patients were asymptomatic, and most of the DVTs occurred 1 or 2 days after surgery.
本研究旨在探讨择期关节镜肩关节手术后静脉血栓栓塞症（VTE）的发生率。
纳入了 175 例连续接受关节镜肩关节手术的患者（平均年龄 61 岁）。排除术前有 VTE 且接受创伤手术或关节置换术的患者。所有患者术后均使用足泵或弹性袜进行深静脉血栓形成（DVT）预防。术前和术后通过超声评估四肢的 DVT。通过计算机断层肺动脉造影诊断肺栓塞。评估与 DVT 相关的危险因素。
175 例患者中，共有 10 例（5.7%）发生 DVT。大多数 DVT 病例在术后 1 至 2 天检测到。所有患者均无症状。无有症状的肺栓塞患者。然而，1 例患者在 3 个月随访期间出现无症状肺栓塞。在危险因素方面，DVT 组与非 DVT 组之间无显著差异。
我们的数据表明，择期关节镜肩关节手术后发生有症状的 VTE 较为罕见。然而，即使采取 DVT 预防措施，也可能发生无症状 VTE。由于大多数 DVT 发生在小腿静脉，因此我们建议即使在关节镜肩关节手术后，外科医生也应注意下肢 DVT 的可能性。择期关节镜肩关节手术后无症状 VTE 的发生率为 5.7%。所有患者均无症状，大多数 DVT 发生在术后 1 或 2 天。
