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儿童和青少年膝关节镜检查后症状性肺栓塞和深静脉血栓形成的发生率。

Incidence of Symptomatic Pulmonary Embolus and Deep Vein Thrombosis After Knee Arthroscopy in the Pediatric and Adolescent Population.

机构信息

Division of Shoulder and Sports Medicine Surgery, Department of Orthopaedic Surgery, University of California San Francisco Medical Center, San Francisco, California.

Department of Pediatric Orthopaedics, University of California San Francisco Medical Center, Children's Hospital of Oakland, Oakland, California.

出版信息

Clin J Sport Med. 2019 Jul;29(4):276-280. doi: 10.1097/JSM.0000000000000519.

Abstract

OBJECTIVE

The incidence of deep venous thrombosis (DVT) and pulmonary embolism (PE) after pediatric knee arthroscopy is unknown. The purpose of this study was to determine the incidence of venous thromboembolism (VTE) after knee arthroscopy in the pediatric and adolescent population in a high-volume center.

DESIGN

Retrospective cohort study.

SETTING

Tertiary care children's hospital.

PATIENTS

All patients who underwent arthroscopy of the knee for a sports-related injury by 2 surgeons were reviewed. Chief complaint, past medical/surgical history, medications, procedure performed, intraoperative findings, intraoperative complications, and postoperative recovery were reviewed. The incidences of postoperative VTE within 30 days after the procedure were reviewed.

RESULTS

Seven hundred forty-six (358 male and 388 female patients) knee arthroscopies performed from September 2011 to October 2016 by 2 pediatric orthopedic surgeons specializing in sports-related injuries were included. The average age was 15.2 ± 2.72 years. Five patients were suspected to have either DVT or PE postoperatively (0.67%). The overall incidence of symptomatic confirmed VTE after knee arthroscopic procedures was 0.27% (one DVT after a partial lateral meniscectomy and one PE after fixation of an osteochondral lesion).

CONCLUSIONS

The incidence of VTE after pediatric sports medicine knee arthroscopies is low, 0.27%. Patients who present with calf swelling or pain, chest pain, or shortness of breath after arthroscopic surgery should be examined closely.

LEVEL OF EVIDENCE

Level III.

摘要

目的

小儿膝关节镜检查后深静脉血栓形成(DVT)和肺栓塞(PE)的发生率尚不清楚。本研究的目的是确定在高容量中心,小儿和青少年膝关节镜检查后静脉血栓栓塞(VTE)的发生率。

设计

回顾性队列研究。

地点

三级儿童保健医院。

患者

回顾了由 2 位外科医生为运动相关损伤进行膝关节镜检查的所有患者。回顾主诉、既往病史/手术史、药物、进行的手术、术中发现、术中并发症和术后恢复情况。回顾了手术后 30 天内术后 VTE 的发生率。

结果

共纳入了 746 例(358 例男性和 388 例女性)由 2 名专门从事运动相关损伤的小儿矫形外科医生进行的膝关节镜检查。平均年龄为 15.2±2.72 岁。术后有 5 例患者疑似 DVT 或 PE(0.67%)。膝关节镜手术后有症状的确诊 VTE 的总发生率为 0.27%(1 例部分外侧半月板切除术患者发生 DVT,1 例骨软骨病变固定术患者发生 PE)。

结论

小儿运动医学膝关节镜检查后 VTE 的发生率较低,为 0.27%。膝关节镜手术后出现小腿肿胀或疼痛、胸痛或呼吸急促的患者应密切检查。

证据水平

III 级。

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