Fishmann A J, Greeno R A, Brooks L R, Matta J M
Department of Medicine, Hospital of the Good Samaritan, Los Angeles, CA.
Clin Orthop Relat Res. 1994 Aug(305):133-7.
In a prospective nonrandomized study, a protocol was examined for prophylaxis of deep venous thrombosis and pulmonary embolism in patients with operative treatment of acetabular and pelvic fractures. There were 197 patients in the study with 203 fractures, including 148 acetabular and 55 pelvic fractures. There were 2 cases of bilateral acetabular fractures and 4 cases with both acetabular and pelvic fractures. The protocol involved preoperative noninvasive screening of the lower extremities, intraoperative and postoperative use of mechanical antithrombotic devices, and chemical prophylaxis with warfarin for 3 weeks following removal of surgical drains. There were 11 cases (6%) of preoperative deep venous thrombosis detected. There were 6 cases of postoperative deep venous thrombosis and 2 cases of pulmonary embolism. The incidence of postoperative venous thrombosis and pulmonary embolism was 3% and 1%, respectively. The protocol was found to be effective for preoperative detection of venous thrombosis and prevention of deep venous thrombosis and pulmonary embolism in trauma patients with minimal bleeding complications and no morbidity from embolic disease.
在一项前瞻性非随机研究中，对髋臼和骨盆骨折手术治疗患者预防深静脉血栓形成和肺栓塞的方案进行了研究。该研究中有197例患者，共203处骨折，其中髋臼骨折148处，骨盆骨折55处。有2例双侧髋臼骨折，4例同时存在髋臼和骨盆骨折。该方案包括术前对下肢进行无创筛查，术中及术后使用机械抗血栓装置，并在拔除手术引流管后用华法林进行3周的化学预防。术前检测到11例（6%）深静脉血栓形成。术后有6例深静脉血栓形成和2例肺栓塞。术后静脉血栓形成和肺栓塞的发生率分别为3%和1%。该方案被发现对于术前检测静脉血栓形成以及预防创伤患者的深静脉血栓形成和肺栓塞有效，且出血并发症极少，也未出现栓塞性疾病的发病情况。
