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一例关节镜下多韧带重建术后无症状双侧大面积肺栓塞病例。

A case of asymptomatic bilateral massive pulmonary embolism after arthroscopic multiple knee ligament reconstruction.

作者信息

Takigami Junsei, Hashimoto Yusuke, Yamasaki Shinya, Terai Shozaburo, Nakamura Hiroaki

机构信息

Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2017 Jan;25(1):260-262. doi: 10.1007/s00167-014-3466-7. Epub 2014 Dec 11.

Abstract

Venous thromboembolism, which includes deep venous thrombosis (DVT) and pulmonary embolism (PE), is a serious complication after operations involving the lower extremities, and it can be fatal. However, few reports have described the incidence of PE and its associated risk factors after arthroscopic knee surgery. We present a case of bilateral massive PE of the main pulmonary arteries and DVT detected on multi-detector row computed tomography after arthroscopic multiple knee ligament reconstruction. Our patient was asymptomatic despite having several risk factors for thromboembolic events (43 years of age, a long operation time, obesity, and diabetes mellitus) and receiving no pharmacologic thromboembolic prophylaxis. Although fatality due to PE is relatively uncommon, when a patient has several risk factors for PE, perioperative thromboprophylaxis should be considered. Level of evidence IV.

摘要

静脉血栓栓塞症,包括深静脉血栓形成(DVT)和肺栓塞(PE),是下肢手术后的一种严重并发症,可能会致命。然而,很少有报告描述关节镜膝关节手术后PE的发生率及其相关危险因素。我们报告一例在关节镜下多次膝关节韧带重建术后,通过多排探测器计算机断层扫描检测到的双侧主肺动脉大面积PE和DVT病例。尽管我们的患者有几个血栓栓塞事件的危险因素(43岁、手术时间长、肥胖和糖尿病)且未接受药物性血栓栓塞预防,但患者并无症状。虽然因PE导致的死亡相对不常见,但当患者有多个PE危险因素时,应考虑围手术期血栓预防。证据等级IV。

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