Abdul Halim Wan Muhamad Amir, Leong Juzaily F, Hayyun Muhammad Fathi, Abdul Rani Rizal, Mohamad Yahaya Nor Hamdan
Orthopaedics and Traumatology, University Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MYS.
Cureus. 2024 Sep 7;16(9):e68870. doi: 10.7759/cureus.68870. eCollection 2024 Sep.
Pulmonary embolism (PE) is a life-threatening condition that occurs due to the blockage of the pulmonary artery by blood clots. The occurrence of PE after total knee arthroplasty (TKA) is quite rare. Individuals with a history of PE have a high risk of recurrent venous thromboembolism (VTE). We have encountered a case of saddle PE (SPE) following TKA. The patient underwent a TKA due to advanced osteoarthritis. She started to develop respiratory distress after day 2 of surgery. Further investigation showed that she developed SPE. The conclusion from this case is that, while the occurrence is rare, it is critical to identify the risk factors for each patient prior to surgery. Individuals with VTE are at risk of developing recurrent VTE. Those with a previous history of VTE may require long-term anticoagulant medication to prevent a recurrence. Early diagnosis of the risk factor for VTE before the surgical procedure helps assure a positive outcome and prognosis following the procedure. As an additional benefit, it will lower the rates of perioperative morbidity and mortality.
肺栓塞（PE）是一种危及生命的疾病，由于血凝块阻塞肺动脉而发生。全膝关节置换术（TKA）后发生PE的情况相当罕见。有PE病史的个体发生复发性静脉血栓栓塞（VTE）的风险很高。我们遇到了一例TKA术后鞍状肺栓塞（SPE）的病例。该患者因重度骨关节炎接受了TKA手术。术后第2天开始出现呼吸窘迫。进一步检查显示她发生了SPE。该病例的结论是，虽然发生率很低，但在手术前识别每位患者的危险因素至关重要。有VTE的个体有发生复发性VTE的风险。有VTE既往史的患者可能需要长期抗凝药物来预防复发。在手术前早期诊断VTE的危险因素有助于确保手术有良好的结果和预后。另外一个好处是，它将降低围手术期的发病率和死亡率。
