Lachiewicz P F, Klein J A, Holleman J B, Kelley S
Division of Orthopaedic Surgery, University of North Carolina School of Medicine, Chapel Hill 27599-7055, USA.
J South Orthop Assoc. 1996 Winter;5(4):272-80.
We prospectively studied the use of either aspirin or intermittent pneumatic compression (IPC) as prophylaxis against thromboembolism after 330 consecutive total hip arthroplasties. Duplex ultrasonography of the veins of both lower extremities and ventilation-perfusion lung scans were done preoperatively and 7 to 14 days postoperatively. Eight patients in the IPC group (5%) had asymptomatic deep vein thrombosis; there were no symptomatic thrombi. In the aspirin group, 10 patients (7%) had asymptomatic deep vein thrombosis and two patients (1%) had symptomatic deep vein thrombosis. This difference was not statistically significant. There were no fatal pulmonary emboli in either group. In the IPC group, only one patient had symptomatic pulmonary embolism and 20 patients (22 hips [12%]) had asymptomatic pulmonary embolism. In the aspirin group, two patients (1%) had symptomatic pulmonary embolism and 26 patients (18%) had asymptomatic pulmonary embolism. This difference in asymptomatic pulmonary embolism between the two groups was statistically significant. Both groups had a low incidence of deep vein thrombosis, as shown by Duplex ultrasonography, but IPC was more effective than aspirin in preventing asymptomatic pulmonary embolism after total hip arthroplasty.
我们对连续330例全髋关节置换术后使用阿司匹林或间歇性气动压迫（IPC）预防血栓栓塞进行了前瞻性研究。术前及术后7至14天对双下肢静脉进行了双功超声检查，并进行了通气-灌注肺扫描。IPC组有8例患者（5%）发生无症状深静脉血栓形成；无有症状血栓形成。阿司匹林组有10例患者（7%）发生无症状深静脉血栓形成，2例患者（1%）发生有症状深静脉血栓形成。这种差异无统计学意义。两组均无致命性肺栓塞。IPC组仅1例患者发生有症状肺栓塞，20例患者（22髋[12%]）发生无症状肺栓塞。阿司匹林组2例患者（1%）发生有症状肺栓塞，26例患者（18%）发生无症状肺栓塞。两组间无症状肺栓塞的这种差异具有统计学意义。双功超声检查显示两组深静脉血栓形成发生率均较低，但IPC在预防全髋关节置换术后无症状肺栓塞方面比阿司匹林更有效。
