Çolak İlker, Gülabi Deniz, Eceviz Engin, Çevik Bilgehan H, Bulut Güven, Bekler Halil I
J Am Podiatr Med Assoc. 2020 Jan;110(1):Article3. doi: 10.7547/17-012. Epub 2017 Nov 13.
Surgical or nonsurgical treatment of an Achilles tendon rupture includes a period of immobilization that is a well-documented risk factor for deep venous thrombosis (DVT). The DVT is a source of morbidity in orthopedic surgery because it can progress to pulmonary embolism. The aim of this study was to investigate the incidence of DVT and pulmonary embolism after surgical treatment of an Achilles tendon rupture.
A retrospective analysis was made of patients who underwent surgical treatment of Achilles tendon rupture between January 1, 2006, and November 30, 2014. Patient data were collected from the hospital medical record system.
Of 238 patients with a mean age of 39 years (range, 18-66 years), 18 (7.6%) were diagnosed as having symptomatic DVT. The average body mass index of the patients with DVT was 31.8 (range, 24-33). Of the patients with DVT, 11 were older than 40 years and two-thirds had a body mass index of 30 or greater. Pulmonary embolism was diagnosed in four patients (1.7%), none of whom had DVT symptoms.
Venous thrombosis continues to be a major cause of morbidity and mortality in postoperative patients. Limited data are available for the use of thromboprophylaxis in foot and ankle surgery. In light of the literature review and results of this study, we suggest that routine thromboembolism prophylaxis should be considered for patients with Achilles tendon rupture.
跟腱断裂的手术或非手术治疗都包括一段固定期，而这是深静脉血栓形成（DVT）的一个已被充分证实的危险因素。深静脉血栓形成是骨科手术中发病的一个原因，因为它可能进展为肺栓塞。本研究的目的是调查跟腱断裂手术治疗后深静脉血栓形成和肺栓塞的发生率。
对2006年1月1日至2014年11月30日期间接受跟腱断裂手术治疗的患者进行回顾性分析。患者数据从医院病历系统中收集。
238例患者的平均年龄为39岁（范围18 - 66岁），其中18例（7.6%）被诊断为有症状的深静脉血栓形成。深静脉血栓形成患者的平均体重指数为31.8（范围24 - 33）。在深静脉血栓形成患者中，11例年龄大于40岁，三分之二的患者体重指数为30或更高。4例患者（1.7%）被诊断为肺栓塞，其中无一例有深静脉血栓形成症状。
静脉血栓形成仍然是术后患者发病和死亡的主要原因。关于在足踝手术中使用血栓预防措施的数据有限。根据文献综述和本研究结果，我们建议对于跟腱断裂患者应考虑常规的血栓栓塞预防措施。
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