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使用或不使用低分子量肝素的机械压迫装置行全膝关节置换术后深静脉血栓形成和肺栓塞的发生率

Incidences of Deep Vein Thrombosis and Pulmonary Embolism after Total Knee Arthroplasty Using a Mechanical Compression Device with and without Low-Molecular-Weight Heparin.

作者信息

Park Sin Hyung, Ahn Joong Hyeon, Park Yong Bok, Lee Sun Geun, Yim Soo Jae

机构信息

Department of Orthopedic Surgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.

出版信息

Knee Surg Relat Res. 2016 Sep;28(3):213-8. doi: 10.5792/ksrr.2016.28.3.213. Epub 2016 Aug 25.

Abstract

PURPOSE

To investigate the incidence of thromboembolic events and complications related to bleeding after total knee arthroplasty (TKA) with a mechanical compression device alone or in combination with low-molecular-weight heparin (LMWH).

MATERIALS AND METHODS

A total of 489 TKA patients (776 knees) were retrospectively reviewed for the incidence of thromboembolic events and complications related to bleeding. While 233 patients (354 knees) were treated with a mechanical compressive device without LMWH, 256 patients (422 knees) were treated with the mechanical compressive device along with LMWH.

RESULTS

The incidences of deep vein thrombosis (DVT) and pulmonary embolism (PE) were 15 of 375 knees (4.0%) and 5 of 375 knees (1.3%), respectively, in the group that used only a mechanical compressive device, and 14 of 401 knees (3.4%) and 5 of 401 knees (1.2%), respectively, in the group that used the mechanical compressive device with LMWH. There was no significant difference between the two groups (p=0.125 and p=0.146, respectively). The postoperative hemovac drainage amount was 635±57 mL in the group with a mechanical compressive device only and 813±84 mL in the group with the device and LMWH; therefore, the amount of drainage was significantly greater in the latter group (p=0.013).

CONCLUSIONS

Mechanical compression alone for prophylaxis against DVT and PE after TKA can be an attractive option in Korean patients.

摘要

目的

研究单纯使用机械压迫装置或联合低分子肝素(LMWH)进行全膝关节置换术(TKA)后血栓栓塞事件及出血相关并发症的发生率。

材料与方法

回顾性分析489例TKA患者(776膝)的血栓栓塞事件及出血相关并发症的发生率。其中233例患者(354膝)仅使用机械压迫装置治疗,未使用LMWH;256例患者(422膝)使用机械压迫装置联合LMWH治疗。

结果

单纯使用机械压迫装置的组中,375膝中有15例(4.0%)发生深静脉血栓(DVT),375膝中有5例(1.3%)发生肺栓塞(PE);使用机械压迫装置联合LMWH的组中,401膝中有14例(3.4%)发生DVT,401膝中有5例(1.2%)发生PE。两组之间无显著差异(p分别为0.125和0.146)。单纯使用机械压迫装置组术后负压引流血量为635±57 mL,使用装置联合LMWH组为813±84 mL;因此,后一组的引流量显著更多(p=0.013)。

结论

对于韩国患者,TKA术后单纯使用机械压迫预防DVT和PE可能是一个有吸引力的选择。

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