Brooks R L, Winslow M C, Kenmore P I
Orthopedics. 1987 Sep;10(9):1287-8.
Occasional patients will present a week or more after sustaining a hip fracture. Though these patients are at high risk for asymptomatic deep venous thrombosis and pulmonary embolism, anticoagulation may be contraindicated prior to surgery. Two recent cases involving such a situation are reported. In the first, the patient sustained a fatal intraoperative pulmonary embolism. In the second, a transvenous Greenfield vena caval filter was placed prior to surgery. An extremely high suspicion of asymptomatic deep venous thrombosis is necessary when evaluating a patient whose hip fracture has been untreated for a week or more. If studies demonstrate a deep venous thrombosis preoperatively, placement of an inferior vena caval filter may be indicated.
偶尔会有患者在髋部骨折一周或更长时间后才前来就诊。尽管这些患者发生无症状深静脉血栓形成和肺栓塞的风险很高，但在手术前抗凝治疗可能是禁忌的。本文报告了最近涉及这种情况的两例病例。第一例中，患者在术中发生致命性肺栓塞。第二例中，在手术前放置了经静脉格林菲尔德下腔静脉滤器。在评估髋部骨折未治疗一周或更长时间的患者时，必须高度怀疑其有无症状深静脉血栓形成。如果术前检查显示有深静脉血栓形成，则可能需要放置下腔静脉滤器。
