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面骨骨折治疗后发生的静脉血栓栓塞——一篇临床论文及综述

Venous Thromboembolism Subsequent to the Management of Panfacial Fracture- A Clinical Paper and Review.

作者信息

Nayak Sunil S, Taranath Kamath Abhay, Roy Sreea, Singh Anupam, Puri Smriti, Pai Deepika

机构信息

Manipal College of Dental Sciences, Academy of Higher Education, Manipal, India.

Department of Oral and Maxillofacial Surgery, KMC Hospital, Dr BR Ambedkar Circle, Mangalore, India.

出版信息

J Maxillofac Oral Surg. 2025 Feb;24(1):153-161. doi: 10.1007/s12663-024-02379-y. Epub 2024 Dec 18.

Abstract

BACKGROUND

Venous thromboembolism (VTE) is a major factor responsible for death in patients suffering from prolonged immobilisation due to various causes like old age, pregnancy, stroke, and prolonged surgical procedures to mention a few. Long-duration surgeries as in fixation and reconstruction in panfacial fractures and facial orthognathic surgeries can be potential cases predisposed for VTE in maxillofacial surgery.

METHOD

A fifty-eight-year-old patient suffered from pulmonary thromboembolism following long-duration surgery for panfacial fracture fixation and reconstruction under general anaesthesia. He was promptly managed via medical management and recovered well.

DISCUSSION

Pulmonary thromboembolism is a severe complication that can lead to severe morbidity or even death. Owing to the characteristics of venous thrombosis, all collaborating healthcare team members should be trained to assess risk factors for efficient diagnosis which can facilitate specialised intervention that can result in better patient outcomes.

CONCLUSION

Maxillofacial surgeons need to evaluate the risk of thromboembolism in patients and institute efficient diagnosis whenever required to deliver optimised and better patient care. Although thromboembolism is a preventable disease state, the key is to keep a close eye on the patient's clinical features to identify and treat them at the right time for better patient care and survival.

摘要

背景

静脉血栓栓塞症(VTE)是导致因多种原因(如老年、妊娠、中风和长时间外科手术等)而长期卧床的患者死亡的主要因素。在颌面外科手术中,像全颜面骨折的固定与重建以及面部正颌手术等长时间手术,可能是易发生VTE的潜在病例。

方法

一名58岁患者在全身麻醉下接受全颜面骨折固定与重建的长时间手术后发生了肺血栓栓塞。他通过药物治疗得到及时处理,恢复良好。

讨论

肺血栓栓塞是一种严重的并发症,可导致严重的发病甚至死亡。鉴于静脉血栓形成的特点,所有参与协作的医疗团队成员都应接受培训,以评估风险因素,从而进行有效的诊断,这有助于开展专业干预,进而改善患者预后。

结论

颌面外科医生需要评估患者发生血栓栓塞的风险,并在需要时进行有效的诊断,以提供优化的、更好的患者护理。尽管血栓栓塞是一种可预防的疾病状态,但关键是密切关注患者的临床特征,以便在正确的时间识别并治疗,从而实现更好的患者护理和生存。

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本文引用的文献

1
An Unusual Case of Deep Vein Thrombosis After Orthognathic Surgery: A Case Report and Review of the Literature.
J Oral Maxillofac Surg. 2018 Dec;76(12):2649.e1-2649.e9. doi: 10.1016/j.joms.2018.07.024. Epub 2018 Jul 30.
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Venous thromboembolism in oral and maxillofacial surgery: a review of the literature.
J Oral Maxillofac Surg. 2011 Mar;69(3):840-4. doi: 10.1016/j.joms.2010.11.025. Epub 2011 Jan 20.
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A history of pulmonary embolism and deep venous thrombosis.有肺栓塞和深静脉血栓形成病史。
Crit Care Clin. 2009 Jan;25(1):115-31, viii. doi: 10.1016/j.ccc.2008.12.014.
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Prevention of venous thromboembolism after surgery.
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