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关节镜下后交叉韧带重建术后深静脉血栓形成的发生率及危险因素

Incidence and risk factors of deep venous thrombosis following arthroscopic posterior cruciate ligament reconstruction.

作者信息

Chen Dongyang, Li Qiangqiang, Rong Zhen, Yao Yao, Xu Zhihong, Shi Dongquan, Jiang Qing

机构信息

Department of Sports Medicine and Adult Reconstructive Surgery, Nanjing Drum Tower Hospital Affiliated with the Medical School of Nanjing University, Nanjing Jiangsu Department of Sports Medicine and Adult Reconstructive Surgery, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing Laboratory for Bone and Joint Diseases, Model Animal Research Center, Nanjing University, Nanjing, Jiangsu Department of Orthopedics, The Third Affiliated Hospital of Soochow University, Suzhou, China.

出版信息

Medicine (Baltimore). 2017 Jun;96(22):e7074. doi: 10.1097/MD.0000000000007074.

Abstract

The objective of this study was to identify the incidence and associated risk factors for deep venous thrombosis (DVT) after arthroscopic posterior cruciate ligament (PCL) reconstruction.This study included 128 patients who underwent arthroscopic PCL reconstruction. Venography was performed on the operated leg 3 days postoperatively. The patients were divided into 2 groups based on whether they had DVT. A correlation analysis was performed to determine the factors associated with DVT.Of all the 128 patients, 28 patients (21.9%) developed DVT, with 4 (3.1%) in a proximal location. Significant differences were found in the mean age, time of application of tourniquet, mean VAS scores, mean D-dimer level, mean cholesterol level, and various surgical procedures in patients with DVT compared with those without DVT. DVT is difficult to diagnose solely based on clinical symptoms.The incidence of DVT was 21.9% in patients who underwent arthroscopic PCL reconstruction. The rate of asymptomatic clots in the calf region was rather high after PCL reconstruction, and the rate of proximal clots was 4%. Older age, longer durations of tourniquet application, higher VAS scores and D-dimer levels, and complex surgical procedures were all substantial risk factors for DVT after PCL reconstruction. The treatment of DVT with batroxobin and anticoagulants was effective and safe.

摘要

本研究的目的是确定关节镜下后交叉韧带(PCL)重建术后深静脉血栓形成(DVT)的发生率及相关危险因素。本研究纳入了128例行关节镜下PCL重建术的患者。术后3天对术侧下肢进行静脉造影。根据患者是否发生DVT将其分为两组。进行相关性分析以确定与DVT相关的因素。在所有128例患者中,28例(21.9%)发生DVT,其中4例(3.1%)为近端DVT。与未发生DVT的患者相比,发生DVT的患者在平均年龄、止血带应用时间、平均视觉模拟评分(VAS)、平均D-二聚体水平、平均胆固醇水平以及各种手术操作方面存在显著差异。仅根据临床症状很难诊断DVT。关节镜下PCL重建术患者的DVT发生率为21.9%。PCL重建术后小腿区域无症状血栓的发生率相当高,近端血栓的发生率为4%。年龄较大、止血带应用时间较长、VAS评分和D-二聚体水平较高以及手术操作复杂均是PCL重建术后DVT的重要危险因素。用巴曲酶和抗凝剂治疗DVT有效且安全。

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