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比较全髋关节置换术后急性下肢远端深静脉血栓形成患者接受或未接受抗凝治疗的残余血栓形成和静脉血栓栓塞结局。

Comparing residual thrombosis and venous thromboembolism outcomes between patients treated with or without anticoagulant therapy for acute distal lower-limb deep vein thrombosis after total hip arthroplasty.

作者信息

Tone Shine, Naito Yohei, Wakabayashi Hiroki, Sudo Akihiro, Hasegawa Masahiro

机构信息

Department of Orthopaedic Surgery, Graduate School of Medicine, Mie University, Tsu, Japan.

Yonaha Okanoue Hospital, Kuwana, Japan.

出版信息

Eur J Orthop Surg Traumatol. 2025 Apr 25;35(1):167. doi: 10.1007/s00590-025-04291-8.

Abstract

PURPOSE

This study aimed to evaluate the necessity of anticoagulant therapy with an Xa inhibitor for asymptomatic acute distal lower-limb deep vein thrombosis (DVT) detected on ultrasonography after total hip arthroplasty (THA).

METHODS

After exclusions, patients who underwent primary cementless THA were divided into treatment and no-treatment groups based on whether they received anticoagulant therapy with an Xa inhibitor for asymptomatic acute distal lower-limb DVT. Residual distal lower-limb DVT at 3 months, incidence of proximal DVT, and symptomatic venous thromboembolism (VTE) after THA were compared between the groups.

RESULTS

A total of 574 patients met the inclusion criteria (treatment group, n = 287; no-treatment group, n = 287). Residual distal lower-limb DVT at 3 months was detected in 3 patients (1.0%) in the treatment group and in 10 patients (3.5%) in the no-treatment group. No symptomatic VTE was observed in either group. No significant difference was observed between the two groups, although the no-treatment group tended to have a higher residual rate of acute distal lower-limb DVT.

CONCLUSION

The necessity of anticoagulant therapy for asymptomatic acute distal lower-limb DVT was not confirmed.

摘要

目的

本研究旨在评估全髋关节置换术(THA)后超声检查发现的无症状急性下肢远端深静脉血栓形成(DVT)患者使用Xa因子抑制剂进行抗凝治疗的必要性。

方法

排除相关病例后,接受初次非骨水泥型THA的患者根据是否接受Xa因子抑制剂抗凝治疗以治疗无症状急性下肢远端DVT分为治疗组和非治疗组。比较两组患者术后3个月下肢远端残余DVT、近端DVT发生率及有症状静脉血栓栓塞症(VTE)的情况。

结果

共有574例患者符合纳入标准(治疗组,n = 287;非治疗组,n = 287)。治疗组3例患者(1.0%)在术后3个月发现下肢远端残余DVT,非治疗组有10例患者(3.5%)出现。两组均未观察到有症状的VTE。两组之间未观察到显著差异,尽管非治疗组急性下肢远端DVT的残余率有升高趋势。

结论

未证实无症状急性下肢远端DVT进行抗凝治疗的必要性。

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