Kapoor Chirag S, Mehta Ashit K, Patel Krunal, Golwala Paresh P
Department of Orthopaedics, Smt. Bhikhiben Kanjibhai Shah Medical Institute & Research Centre, Piparia, Waghodia, Vadodara, Gujarat, India.
J Clin Orthop Trauma. 2016 Oct-Dec;7(Suppl 2):220-224. doi: 10.1016/j.jcot.2016.07.003. Epub 2016 Jul 25.
Venous thrombo-embolism (VTE), which consists of deep vein thrombosis (DVT) and pulmonary embolism, is a potentially fatal condition. According to Western literature, DVT of lower limb veins is one of the most common complications following surgeries for lower limb. Few studies have been published from India on the subject and little is known about the true prevalence of the DVT and hence there are no clear guidelines regarding the prophylaxis for DVT for Indian patients.
We carried out a prospective study to determine the prevalence of DVT in 125 patients with lower limb trauma. All the patients underwent Colour Doppler pre-operatively, 4th post-operative day, at 3rd month post operatively and at 6th month post operatively only in patients who remained DVT positive at 3rd month post operatively, to see for the recanalisation. No mechanical or chemical form of DVT prophylaxis was used in DVT negative patients either pre-operatively or post-operatively.
In our series of 125 patients, 107 were males and 18 females (M:F = 5.9:1). Majority of our DVT positive patients were above 60 years of age. Out of 47 patients with periacetabular fractures, 8.51% developed DVT. Out of 8 patients with floating knee injury, 25% developed DVT. Combination of risk factors rather than a single risk factor had played important role for development of DVT in our study. 6 patients were DVT positive (4.8%). Amongst them 3 (2.4%) had proximal DVT and 3 (2.4%) had distal DVT. There was single case of pulmonary embolism (PE).
静脉血栓栓塞症(VTE)包括深静脉血栓形成(DVT)和肺栓塞,是一种潜在的致命疾病。根据西方文献,下肢静脉深静脉血栓形成是下肢手术后最常见的并发症之一。印度关于该主题的研究很少,对深静脉血栓形成的真实患病率了解甚少,因此对于印度患者深静脉血栓形成的预防没有明确的指南。
我们进行了一项前瞻性研究,以确定125例下肢创伤患者中深静脉血栓形成的患病率。所有患者在术前、术后第4天、术后第3个月进行彩色多普勒检查,仅对术后第3个月仍为深静脉血栓形成阳性的患者在术后第6个月进行检查,以观察再通情况。深静脉血栓形成阴性的患者在术前和术后均未使用机械或化学形式的深静脉血栓形成预防措施。
在我们的125例患者系列中,男性107例,女性18例(男:女 = 5.9:1)。我们的深静脉血栓形成阳性患者大多数年龄在60岁以上。在47例髋臼周围骨折患者中,8.51%发生了深静脉血栓形成。在8例浮动膝损伤患者中,25%发生了深静脉血栓形成。在我们的研究中,危险因素的组合而非单一危险因素在深静脉血栓形成的发生中起了重要作用。6例患者深静脉血栓形成阳性(4.8%)。其中3例(2.4%)发生近端深静脉血栓形成,3例(2.4%)发生远端深静脉血栓形成。有1例肺栓塞(PE)病例。