Khaw F M, Moran C G, Pinder I M, Smith S R
Department of Orthopaedics, Freeman Hospital, Newcastle upon Tyne, UK.
J Bone Joint Surg Br. 1993 Nov;75(6):940-1. doi: 10.1302/0301-620X.75B6.8245087.
We made a prospective study of the incidence of fatal pulmonary embolism in patients after total knee replacement with no prophylactic anticoagulation. There were 499 consecutive patients having 527 knee replacements. They all wore anti-thromboembolic stockings and were mobilised 48 hours after surgery. No patient was lost to follow-up. One patient died of pulmonary embolism 22 days after operation. There were no other deaths within three months of operation. The incidence of fatal pulmonary embolism was 0.19% (95% confidence interval: 0 to 0.6%). Fatal pulmonary embolism is rare after total knee replacement without prophylactic anticoagulation and the routine anticoagulation of these patients is of doubtful value.
我们对未进行预防性抗凝治疗的全膝关节置换术后患者致命性肺栓塞的发生率进行了一项前瞻性研究。共有499例连续患者接受了527次膝关节置换手术。他们均穿着抗血栓栓塞 stockings（此处原文“stockings”可能有误，结合语境推测应为“stockings”即“长袜”），并在术后48小时开始活动。无一例患者失访。1例患者在术后22天死于肺栓塞。术后三个月内无其他死亡病例。致命性肺栓塞的发生率为0.19%（95%置信区间：0至0.6%）。在未进行预防性抗凝治疗的全膝关节置换术后，致命性肺栓塞很少见，对这些患者进行常规抗凝治疗的价值存疑。
