关节镜术后肩部血栓栓塞：回顾性研究。
Thromboembolism Following Shoulder Arthroscopy: A Retrospective Review.
机构信息
Department of Orthopaedic Surgery and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
出版信息
Orthop J Sports Med. 2014 Nov 24;2(11):2325967114559506. doi: 10.1177/2325967114559506. eCollection 2014 Nov.
BACKGROUND
Thromboembolism following shoulder arthroscopy is considered an uncommon complication, with fewer than 50 cases reported in the literature. Arthroscopy of the shoulder is one of the most commonly performed orthopaedic procedures, with low associated risks.
PURPOSE
To identify potential risk factors for the development of venous thromboembolism (VTE) following shoulder arthroscopy and to determine the overall incidence of this complication.
STUDY DESIGN
Case-control study; Level of evidence, 3.
METHODS
A retrospective case-control review was performed of patients who developed symptomatic deep venous thrombosis (DVT) or pulmonary embolism (PE) following shoulder arthroscopy. Multiple surgeons from across North America were queried. For every case of DVT or PE identified, 2 control cases of shoulder arthroscopy were analyzed. The incidence of DVT/PE following shoulder arthroscopy was determined. A univariate analysis and a multivariate logistic regression model were conducted to identify any potential risk factors for the development of VTE following shoulder arthroscopy.
RESULTS
A total of 17 surgeons participated in this study and had performed a total of 15,033 cases of shoulder arthroscopy from September 2002 through August 2011. Eleven of the 17 participating surgeons had had a patient with a VTE complication during this time frame. The incidence of VTE in the 15,033 cases was 0.15%; 22 patients of the 15,033 patients had a DVT (n = 15) and/or PE (n = 8). Forty-four control cases were also analyzed. Univariate and multivariate analyses were performed. No significant risk factors were identified other than patient positioning. All cases and controls were positioned in the beach-chair position for surgery.
CONCLUSION
The results of this study show that although rare, VTE occurs following shoulder arthroscopy at a rate of 0.15%. The variables analyzed in the cases of VTE compared with the control cases did not show any significant risk factors. All cases were positioned in the beach-chair position. Further analysis of future cases is warranted.
背景
肩关节镜术后发生血栓栓塞被认为是一种罕见的并发症，文献中报道的病例少于 50 例。肩关节镜检查是最常见的骨科手术之一，相关风险较低。
目的
确定肩关节镜术后发生静脉血栓栓塞（VTE）的潜在危险因素，并确定这种并发症的总体发生率。
研究设计
病例对照研究；证据水平，3 级。
方法
对肩关节镜术后出现症状性深静脉血栓形成（DVT）或肺栓塞（PE）的患者进行回顾性病例对照研究。来自北美的多位外科医生参与了这项研究。每例 DVT 或 PE 患者都分析了 2 例肩关节镜检查的对照患者。确定肩关节镜术后 DVT/PE 的发生率。进行单变量分析和多变量逻辑回归模型，以确定肩关节镜术后发生 VTE 的任何潜在危险因素。
结果
共有 17 名外科医生参与了这项研究，自 2002 年 9 月至 2011 年 8 月共进行了 15033 例肩关节镜手术。在这段时间内，17 名参与研究的外科医生中有 11 名患者发生了 VTE 并发症。在 15033 例患者中，VTE 的发生率为 0.15%；22 例患者出现 DVT（n=15）和/或 PE（n=8）。还分析了 44 例对照病例。进行了单变量和多变量分析。除了患者体位外，未发现其他显著的危险因素。所有病例和对照患者均采用沙滩椅体位进行手术。
结论
本研究结果表明，尽管罕见，但肩关节镜术后 VTE 的发生率为 0.15%。与对照组相比，VTE 病例分析的变量未显示任何显著的危险因素。所有病例均采用沙滩椅体位。需要进一步分析未来的病例。
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