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单机构接受大型髋关节手术患者静脉血栓栓塞的发生率:一项前瞻性研究。

Incidence of Venous Thromboembolism in Patients Undergoing Major Hip Surgeries at a Single Institution: A Prospective Study.

作者信息

Yamanaka Yasuhiro, Ito Hiroshi

机构信息

Department of Orthopedic Surgery, Sapporo City General Hospital, Sapporo, Japan.

Department of Orthopedic Surgery, Asahikawa Medical University, Asahikawa, Japan.

出版信息

Open Orthop J. 2016 Jul 15;10:252-7. doi: 10.2174/1874325001610010252. eCollection 2016.

Abstract

BACKGROUND

Venous thoromboembolism (VTE) is one of the most significant complications after hip surgeries. Many studies have been reported about the incidence of VTE after THA, but a small number of reports were found concerning Periacetabular osteotomy, Revision THA and Surgery for hip fracture postoperatively. Furthermore, there exists no comparative study of the incidence of VTE among major hip surgeries at a single institution. We reported the incidence of VTE among hip surgeries performed at a single institution.

METHODS

A total of 820 Hip surgeries were performed at same institution. The procedures included 420 hips that underwent primary total hip arthroplasties (THA), 91 revision or removal of total hip arthroplasties (Revision THA), 144 periacetabular osteotomy (PAO) and 165 surgery for hip fracture (SHF) between 2006 and 2012. VTE was detected by Multidetector computed tomography (MDCT) that scanned 768 cases and by ultrasound that scanned 52cases postoperative 10-14 days.

RESULTS

The overall incidence of VTE was 12.2% (100 of 820). The incidence of VTE after THA was 13.1% (55 of 420), Revision THA was 13.2% (12 of 91), PAO was 2.1% (3 of 144) and SHF was 18.1% (30 of 165). The incidence of VTE was significantly higher in SHF than in PAO.

CONCLUSION

This data indicates that the incidence of VTE after PAO is significantly lower than SHF and relatively lower than THA and Revision THA. A younger age and non-invasion of the bone marrow of the femur may have affected the result. Prophylaxis therapy was effective especially on SHF.

摘要

背景

静脉血栓栓塞症(VTE)是髋关节手术后最严重的并发症之一。关于全髋关节置换术(THA)后VTE的发生率已有许多研究报道,但关于髋臼周围截骨术、翻修THA和髋部骨折手术后VTE发生率的报道较少。此外,在单一机构中,尚无关于主要髋关节手术中VTE发生率的比较研究。我们报告了在单一机构进行的髋关节手术中VTE的发生率。

方法

在同一机构共进行了820例髋关节手术。手术包括2006年至2012年间的420例初次全髋关节置换术(THA)、91例全髋关节置换术的翻修或取出术(翻修THA)、144例髋臼周围截骨术(PAO)和165例髋部骨折手术(SHF)。术后10 - 14天,通过对768例患者进行多排螺旋计算机断层扫描(MDCT)以及对52例患者进行超声检查来检测VTE。

结果

VTE的总体发生率为12.2%(820例中的100例)。THA后VTE的发生率为13.1%(420例中的55例),翻修THA为13.2%(91例中的12例),PAO为2.1%(144例中的3例),SHF为18.1%(165例中的30例)。SHF中VTE的发生率显著高于PAO。

结论

该数据表明,PAO后VTE的发生率显著低于SHF,且相对低于THA和翻修THA。年龄较轻以及未侵犯股骨骨髓可能影响了结果。预防性治疗对SHF尤其有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c58/4951781/661d1447cf14/TOORTHJ-10-252_F1.jpg

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