本研究147例膝部骨折患者中,共计25例在手术前发生DVT。在最终经静脉造影证实后,25例均予以放置下腔静脉滤器同时进行骨折内固定手术。25例均未发生PE及其他并发症。骨折后予以抗凝治疗,同时正常进行手术后下肢肌肉及关节功能锻炼。骨折均如期愈合。
对于膝部骨折患者,年龄、性别对DVT不具有临床意义,D-二聚体浓度、骨折类型对DVT差异有统计学意义。放置下腔静脉滤器可确保骨折内固定手术及术后康复安全顺利进行。
参考文献
[1] Juan F. Agudelo,MD,Steven J. Morgan,MD,Wade R. Smith,MD. Venous Thromboembolism in Orthopedic Trauma Patients. Trauma. ORTHOPEDICS 2005;28:1164
[2] 刘建龙,蔺锡侯,崔爱民,贾伟。手术及创伤后下肢深静脉血栓形成的早期溶栓抗凝治疗。中国普通外科杂志,2002,11(7):405-407
[3] 刘春萍,何建国,陆慰萱。流行病学与自然病程。见:王辰(主编)。肺栓塞。北京:人民卫生出版社,2003。第一版,65-71 医.学全.在.线网站www.lindalemus.com
[4] Geerts WH,Pineo GF,Heit JA,et al. Prevention of Venous Thromboembolism:The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 2004,126(Suppl):338S-400S
[5] Geerts WH,Heit JA,Clagett GP,et al. Prevention of Venous Thromboembolism. Chest 2001;119:132S-175S
[6] Lensing AW,Buller HR,Prandoni P,et al. Contrast venography,the gold standard for the diagnosis of deep-vein thrombosis:improvement in observer agreement. Thromb Haemost,1992,67:8-12
[7] Planes A,Vochelle N,Fagola M. Total hip replacement and deep vein thrombosis:A venographic and necropsy study. J Bone Joint Surg P,1990,72:9-13
[8] McRae SJ,Ginsberg JS. The diagnosis evaluation of deep vein thrombosis. Am Heart Hosp J.2004;2(4):205-210