Rong Zhen, Yao Yao, Chen Dongyang, Song Kai, Zheng Minghao, Jiang Qing
Department of Sports Medicine and Adult Reconstruction Surgery, Drum Tower Hospital Affiliated to Medical School of Nanjing University, Zhongshan Road 321, Nanjing, 210008, Jiangsu, People's Republic of China.
Joint Research Center for Bone and Joint Disease, Model Animal Research Center (MARC), Nanjing University, Nanjing, 210093, Jiangsu, People's Republic of China.
Knee Surg Sports Traumatol Arthrosc. 2016 May;24(5):1717-21. doi: 10.1007/s00167-016-4026-0. Epub 2016 Mar 12.
The purpose of the present study was to analyse the incidence of deep venous thrombosis (DVT) before knee arthroscopy in patients who had sustained high-energy knee injuries.
This study included 64 patients who underwent arthroscopic knee surgery as a result of injury from a traffic accident or a high fall. Venography was performed on the injured leg of each patient before arthroscopy. The patients were divided into two groups based on whether they had DVT. Correlation analysis was performed to determine the factors associated with DVT.
A total of 32 (50 %) of the 64 patients had venographic evidence of DVT. Of these DVTs, seven were proximal (10.9 %). The D-dimer (DD) level was significantly higher in the DVT group, especially among the patients whose symptoms had persisted for more than 10 days. DVT is difficult to diagnose solely based on clinical symptoms, as some patients are symptomatic while others exhibit symptoms that could be attributed to trauma.
The incidence of DVT before knee arthroscopy in patients with high-energy knee injuries was 50 %, and the prevalence of proximal DVT was 10.9 %. DD is a sensitive marker for DVT. No patient developed DVT with a DD level lower than 0.8 mg/L, but those with DD level higher than 1.5 mg/L had a much higher incidence of DVT developing in patients who had been injured for more than 10 days. A routine examination to exclude DVT in these patients should be performed before arthroscopy.
IV.
本研究旨在分析高能膝关节损伤患者膝关节镜检查前深静脉血栓形成（DVT）的发生率。
本研究纳入64例因交通事故或高处坠落受伤而接受膝关节镜手术的患者。在关节镜检查前，对每位患者的受伤下肢进行静脉造影。根据患者是否患有DVT将其分为两组。进行相关性分析以确定与DVT相关的因素。
64例患者中共有32例（50%）有静脉造影证据显示存在DVT。在这些DVT中，7例为近端DVT（10.9%）。DVT组的D - 二聚体（DD）水平显著更高，尤其是症状持续超过10天的患者。仅根据临床症状难以诊断DVT，因为有些患者有症状，而有些患者的症状可能归因于创伤。
高能膝关节损伤患者膝关节镜检查前DVT的发生率为50%，近端DVT的患病率为10.9%。DD是DVT的敏感标志物。DD水平低于0.8mg/L的患者未发生DVT，但在受伤超过10天的患者中，DD水平高于1.5mg/L的患者发生DVT的发生率要高得多。在关节镜检查前，应对这些患者进行排除DVT的常规检查。
IV级
