Koh In Jun, Kim Ju Hwan, Kim Man Soo, Jang Sung Won, Kim Chulkyu, In Yong
Department of Orthopaedic Surgery, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea.; Department of Orthopaedic Surgery, The Catholic University of Korea College of Medicine, Seoul, Korea.
Gangseo Himchan Hospital, Seoul, Korea .
J Korean Med Sci. 2016 Mar;31(3):443-8. doi: 10.3346/jkms.2016.31.3.443. Epub 2016 Feb 5.
This study was undertaken to determine the prevalence and the natural course of venous thromboembolism (VTE) without thromboprophylaxis to ascertain whether routine thromboprophylaxis is necessary following unicompartmental knee arthroplasty (UKA) in Korean patients. The medical records and multidetector row computed tomography (MDCT) imaging of the consecutive 77 UKAs in 70 patients were reviewed. In all patients, MDCTs were undertaken preoperatively and at 1-week after surgery, and VTE symptoms were evaluated. At postoperative 6-months, follow-up MDCTs were undertaken in all patients in whom VTEs were newly detected after surgery. VTE lesions were newly detected in 18 (26%) of the 70 patients. However, none of the patients complained of VTE-related symptoms and MDCT demonstrated that all VTEs were small and involved limited portion without lower leg edema or pleuroparenchymal complication. At the 6-month follow up MDCT, all types of VTEs were shown to be completely resolved, regardless of their location. All of the VTE lesions maintained an asymptomatic status for 6-month after surgery. VTE following UKA in Korean patients who do not receive thromboprophylaxis seems to occur frequently, but all of the VTEs are clinically insignificant and all VTEs are spontaneously regressed. Routine thromboprophylaxis or thrombolytic treatment in Korean patients undergoing UKA may not be necessary.
本研究旨在确定未进行血栓预防时静脉血栓栓塞症(VTE)的患病率和自然病程,以确定韩国患者单髁膝关节置换术(UKA)后是否有必要进行常规血栓预防。回顾了70例患者连续77例UKA的病历和多排螺旋计算机断层扫描(MDCT)影像。所有患者在术前和术后1周均进行了MDCT检查,并评估了VTE症状。术后6个月,对所有术后新发现VTE的患者进行了随访MDCT检查。70例患者中有18例(26%)新发现VTE病变。然而,没有患者抱怨VTE相关症状,MDCT显示所有VTE均较小,累及范围有限,无小腿水肿或胸膜实质并发症。在6个月随访MDCT时,所有类型的VTE均显示完全消退,无论其位置如何。所有VTE病变在术后6个月均保持无症状状态。未接受血栓预防的韩国患者UKA后VTE似乎经常发生,但所有VTE在临床上均无显著意义,且所有VTE均自发消退。韩国UKA患者可能无需常规血栓预防或溶栓治疗。