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围手术期对下肢静脉进行超声筛查,对预防骨科患者致命性肺栓塞有效。

Perioperative ultrasound screening of lower extremity veins is effective in the prevention of fatal pulmonary embolism in orthopedic patients.

作者信息

Li Haoran, Li Zhi, Yang Na, Xing Jian, Yuan Huijun, Song Zhe, Wei Xing, Ma Teng, Wang Qian, Wang Pengfei, Zhang Kun

机构信息

Department of Orthopedics and Traumatology, Honghui Hospital, Xi'an Jiaotong University, Xi'an, 710054, China.

Department of Spine Surgery, Xi'an Daxing Hospital, Xi'an, 710000, China.

出版信息

Sci Rep. 2025 Jan 2;15(1):229. doi: 10.1038/s41598-024-84572-0.

Abstract

Patients at high risk of deep vein thrombosis are recommended to undergo lower-extremity ultrasonography to screen for pulmonary embolism (PE); however, there are few reports on whether this can effectively reduce the occurrence of fatal pulmonary embolism (FPE). This study aimed to assess the risk factors associated with PE and to investigate whether perioperative ultrasound screening of lower extremity veins in orthopedic patients can effectively reduce the incidence of FPE. We enrolled 137 patients with PE who underwent orthopedic surgery between 2013 and 2020. Patients were divided into survival and non-survival groups based on whether FPE occurred during hospitalization. Demographic and clinical data were compared between groups. Ultrasound screening was effective in reducing the incidence of FPE in orthopedic patients. Thrombolytic therapy and computed tomography pulmonary angiography (CTPA) were highlighted factors that protect against FPE. Coronary heart disease was found to be independent risk factors for FPE. Proximal thrombus associated with an FPE. Ultrasound screening of the lower limb veins should be routinely performed in orthopedic patients during the perioperative period. Prophylactic inferior vena cava filter implantation, thrombolytic therapy, and CTPA can be performed in patients with suspected PE to reduce its incidence.

摘要

建议深静脉血栓形成高危患者接受下肢超声检查以筛查肺栓塞(PE);然而,关于这是否能有效降低致命性肺栓塞(FPE)的发生率,报道较少。本研究旨在评估与PE相关的危险因素,并调查骨科患者围手术期下肢静脉超声筛查是否能有效降低FPE的发生率。我们纳入了2013年至2020年间接受骨科手术的137例PE患者。根据住院期间是否发生FPE将患者分为生存组和非生存组。比较两组的人口统计学和临床数据。超声筛查可有效降低骨科患者FPE的发生率。溶栓治疗和计算机断层扫描肺动脉造影(CTPA)是预防FPE的突出因素。发现冠心病是FPE的独立危险因素。近端血栓与FPE相关。骨科患者围手术期应常规进行下肢静脉超声筛查。对于疑似PE的患者,可进行预防性下腔静脉滤器植入、溶栓治疗和CTPA以降低其发生率。

相似文献

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Deep Vein Thrombosis and Pulmonary Embolism Considerations in Orthopedic Surgery.骨科手术中深静脉血栓形成和肺栓塞的考量
Orthop Clin North Am. 2017 Apr;48(2):127-135. doi: 10.1016/j.ocl.2016.12.003. Epub 2017 Jan 27.

本文引用的文献

1
Echocardiographic Evaluation of Pulmonary Embolism: A Review.超声心动图评估肺栓塞:综述。
J Am Soc Echocardiogr. 2023 Sep;36(9):906-912. doi: 10.1016/j.echo.2023.05.006. Epub 2023 May 19.
8
The law of unintended consequences: current design challenges in inferior vena cava filters.意外后果定律:当下下腔静脉滤器的设计挑战
Expert Rev Med Devices. 2017 Oct;14(10):805-810. doi: 10.1080/17434440.2017.1374850. Epub 2017 Sep 12.

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