Stulberg B N, Dorr L D, Ranawat C S, Schneider R
Clin Orthop Relat Res. 1982 Aug(168):119-23.
Although this study was performed on a relatively small number of patients undergoing total hip arthroplasty in conjunction with aspirin prophylaxis for postoperative pulmonary embolism, several important points are noted: the use of pre- and postoperative lung perfusion scanning can eliminate a 15% rate of false-positive diagnosis of pulmonary embolism, and pulmonary embolism occurred in approximately 8% of patients undergoing total hip arthroplasty in conjunction with aspirin prophylaxis, without fatality. This occurred despite the inclusion of high-risk patients. "Silent" pulmonary embolization occurred in 4.1% of these patients. Patients who have a history of a thromboembolism, a delayed postoperative course, and two or more risk factors for pulmonary embolism present, are at risk of developing a postoperative pulmonary embolism, despite aspirin therapy, and should be managed more aggressively, i.e., early detection or prophylactic anticoagulation therapy.
尽管本研究是在相对少数接受全髋关节置换术并联合阿司匹林预防术后肺栓塞的患者中进行的，但仍有几个要点值得注意：术前和术后进行肺灌注扫描可消除15%的肺栓塞假阳性诊断率，在接受全髋关节置换术并联合阿司匹林预防的患者中，约8%发生了肺栓塞，无一例死亡。尽管纳入了高危患者，但仍出现了这种情况。这些患者中有4.1%发生了“无症状”肺栓塞。有血栓栓塞病史、术后病程延迟且存在两个或更多肺栓塞危险因素的患者，尽管接受了阿司匹林治疗，仍有发生术后肺栓塞的风险，应采取更积极的管理措施，即早期检测或预防性抗凝治疗。
