Hamilton William G, Reeves James D, Fricka Kevin B, Goyal Nitin, Engh Gerard A, Parks Nancy L
Anderson Orthopaedic Research Institute, Alexandria, Virginia.
Town Center Orthopaedic Associates, Centreville, Virginia.
J Arthroplasty. 2015 Jan;30(1):43-5. doi: 10.1016/j.arth.2014.08.006. Epub 2014 Aug 12.
The purpose of this study was to determine the rate of thromboembolic and bleeding complications when using mechanical prophylaxis with preoperative risk stratification following total knee arthroplasty (TKA). Between 1994 and 2007, 4037 TKAs were performed on 3144 patients at our institution. Mechanical VTE prophylaxis was used for standard risk patients, which included AV impulse foot pumps, thigh high stockings, and early mobilization. Chemoprophylaxis was only given to patients who were at increased thromboembolic risk. The incidence of DVT identified by ultrasound following TKA was 2.1%. A retrospective review showed 1 patient had a fatal pulmonary embolism, and 5 patients had bleeding complications in the knee. We conclude that mechanical thromboembolic prophylaxis using risk stratification is safe and effective following TKA.
本研究的目的是确定在全膝关节置换术（TKA）后使用机械预防措施并进行术前风险分层时血栓栓塞和出血并发症的发生率。1994年至2007年期间，我们机构对3144例患者进行了4037次全膝关节置换术。对于标准风险患者采用机械性静脉血栓栓塞预防措施，包括气动脉冲足泵、大腿高位弹力袜和早期活动。仅对血栓栓塞风险增加的患者给予化学预防。全膝关节置换术后经超声检查确诊的深静脉血栓形成发生率为2.1%。一项回顾性研究显示，1例患者发生致命性肺栓塞，5例患者出现膝关节出血并发症。我们得出结论，全膝关节置换术后采用风险分层的机械性血栓栓塞预防措施是安全有效的。
