Kim Y H, Suh J S
Department of Orthopedic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
J Bone Joint Surg Am. 1988 Jul;70(6):878-82.
The incidence of deep-vein thrombosis was studied in 146 consecutive Korean patients who had a cementless total hip replacement with a porous-coated anatomic prosthesis. All of the patients had discontinued taking aspirin, aspirin-containing compounds, or other antiplatelet medications fourteen days before admission to the hospital for the operation. Deep-vein thrombosis was diagnosed by roentgenographic venography, and pulmonary embolism, by perfusion lung-scanning. There was an unusually low incidence (10 per cent) of deep-vein thrombosis in this series. In contrast to other reports, we did not identify a relationship between deep-vein thrombosis and so-called risk factors such as advanced age, number of venous valves (more than five) in the lower extremity, abnormal coagulation-assay data, certain diseases, or preoperative limitation of mobility. In addition, hypertension, blood group, surgical approach, and choice of cemented or cementless total hip replacement did not seem to affect the incidence of deep-vein thrombosis. There was a low incidence of deep-vein thrombosis in patients in whom obesity, prolonged immobilization postoperatively, varicose veins, and hyperlipemia were not factors.
对146例连续接受多孔涂层解剖型假体非骨水泥全髋关节置换术的韩国患者进行了深静脉血栓形成发生率的研究。所有患者在入院接受手术前14天均已停止服用阿司匹林、含阿司匹林的化合物或其他抗血小板药物。深静脉血栓形成通过X线静脉造影诊断,肺栓塞通过灌注肺扫描诊断。该系列中深静脉血栓形成的发生率异常低(10%)。与其他报告不同的是,我们未发现深静脉血栓形成与诸如高龄、下肢静脉瓣膜数量(超过5个)、凝血分析数据异常、某些疾病或术前活动受限等所谓危险因素之间存在关联。此外,高血压、血型、手术方式以及骨水泥型或非骨水泥型全髋关节置换术的选择似乎均不影响深静脉血栓形成的发生率。在肥胖、术后长期制动、静脉曲张和高脂血症并非影响因素的患者中,深静脉血栓形成的发生率较低。