Rong Zhen, Xu Zhihong, Sun Ye, Yao Yao, Song Kai, Chen Dongyang, Shi Dongquan, Dai Jin, Zheng Minghao, Jiang Qing
aThe Center of Diagnosis and Treatment for Joint Disease, Drum Tower Hospital Affiliated to Medical School of Nanjing University bJoint Research Center for Bone and Joint Disease, Model Animal Research Center (MARC), Nanjing University, Nanjing, Jiangsu, PR China cCentre for Orthopaedic Research, School of Surgery, University of Western Australia, Western Australia, Australia *These authors contributed equally to this study and should be considered as co-first authors.
Blood Coagul Fibrinolysis. 2015 Oct;26(7):762-6. doi: 10.1097/MBC.0000000000000323.
Venous thromboembolism (VTE) is a common complication after major orthopedic surgery. However, the reported rates of deep venous thrombosis (DVT) vary widely. Our aim was to study the incidence of DVT in the nonoperated leg after primary major lower extremity arthroplasty using bilateral venography. The records of patients who underwent total hip arthroplasty (THA) or total knee arthroplasty (TKA) at our institution between August 2013 and August 2014 were reviewed. We examined the records for a total of 380 patients, of which 244 had undergone bilateral venography 3-5 days after THA or TKA. A total of 244 patients undergoing TKA (n = 119) or THA (n = 125) were recruited for this study. DVT was diagnosed in 42 (17.2%) of the 244 patients; nine patients developed DVT in both legs, and four developed DVT only in the nonoperated leg. All of the DVTs were located in calf veins. DVT occurred more frequently after TKA than THA, especially in muscular veins. Female sex and older age were found to be positive risk factors for DVT after THA. The incidence of DVT after major lower arthroplasty is high. DVT in nonoperated legs should be carefully considered because of its potential risks, especially in left. Distal DVT also has a high risk to develop pulmonary embolism (PE). The combination of anticoagulant and pneumatic compression is a good measure to avoid proximal DVT, and it is well tolerated to stop anticoagulant if the patients were diagnosed as having no DVT.
静脉血栓栓塞症（VTE）是大型骨科手术后常见的并发症。然而，报道的深静脉血栓形成（DVT）发生率差异很大。我们的目的是使用双侧静脉造影术研究初次大型下肢关节置换术后非手术侧下肢DVT的发生率。回顾了2013年8月至2014年8月在我院接受全髋关节置换术（THA）或全膝关节置换术（TKA）的患者记录。我们共检查了380例患者的记录，其中244例在THA或TKA术后3 - 5天接受了双侧静脉造影。本研究共纳入244例行TKA（n = 119）或THA（n = 125）的患者。244例患者中有42例（17.2%）被诊断为DVT；9例患者双下肢均发生DVT，4例仅在非手术侧下肢发生DVT。所有DVT均位于小腿静脉。TKA术后DVT的发生率高于THA，尤其是在肌静脉中。女性和高龄被发现是THA术后DVT的阳性危险因素。大型下肢关节置换术后DVT的发生率很高。由于非手术侧下肢DVT存在潜在风险，尤其是左侧，应予以仔细考虑。远端DVT也有很高的发生肺栓塞（PE）的风险。抗凝与气压压迫相结合是避免近端DVT的良好措施，如果患者被诊断为无DVT，则停用抗凝药物耐受性良好。
