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下肢骨折患者接受序贯化学预防后深静脉血栓的发生率和位置。

The Incidence and Location of Deep Vein Thrombosis in Lower Extremity Fracture Patients Receiving Sequential Chemical Prophylaxis.

机构信息

Department of Orthopedic and Traumatology, HongHui Hospital, 12480Xi'an Jiaotong University Health Science Center, Beilin District, Xi'an, Shaanxi Province, China.

出版信息

Clin Appl Thromb Hemost. 2021 Jan-Dec;27:1076029620987630. doi: 10.1177/1076029620987630.

Abstract

To investigate the incidence and location of deep vein thrombosis (DVT) in patients with lower extremity fractures receiving pharmacological thromboprophylaxis with LMWH followed by rivaroxaban. All patients aged ≥18 years with lower extremity fractures were included in the study. Duplex ultrasonography (DUS) was performed in the lower extremities before and after surgery for DVT evaluation. According to the location, the DVT was divided into proximal, distal, and mixed thromboses. According to fracture location, patients were classified as having fractures proximal, around, and distal to the knee. All patients received sequential chemical prophylaxis. A total of 404 patients with a mean age of 44.2 ± 13.8 years were included. The incidence of DVT postoperatively was higher than that preoperatively and at 1 month postoperatively. Patients with fractures proximal and around the knee had higher DVT incidences detected on DUS postoperatively and at 1 month postoperatively. Most DVTs were located in the distal vein. DVT incidence and severity were the highest immediately after surgery. DVT incidence in fractures around and proximal to the knee increased after surgery and at 1 month postoperatively. Although with chemical thromboprophylaxis, distal DVT was the most variable during the early stage.

摘要

研究目的

探讨接受低分子肝素(LMWH)序贯利伐沙班药物预防血栓形成的下肢骨折患者中深静脉血栓(DVT)的发生率和部位。

研究方法

所有年龄≥18 岁的下肢骨折患者均纳入本研究。在术前和术后进行下肢双功能超声(DUS)以评估 DVT。根据部位,将 DVT 分为近端、远端和混合血栓。根据骨折部位,患者分为膝关节近端、周围和远端骨折。所有患者均接受序贯化学预防。共纳入 404 例患者,平均年龄为 44.2±13.8 岁。术后 DVT 的发生率高于术前和术后 1 个月。膝关节近端和周围骨折的患者术后和术后 1 个月 DUS 检查的 DVT 发生率更高。大多数 DVT 位于远端静脉。DVT 发生率和严重程度在术后即刻最高。膝关节周围和近端骨折的 DVT 发生率在术后和术后 1 个月增加。尽管进行了化学预防血栓形成,但在早期,远端 DVT 是最具变异性的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ff5/7995305/7e8688041466/10.1177_1076029620987630-fig1.jpg

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