Incidence of venous thromboembolism using 64 channel multidetector row computed tomography-indirect venography and anti-coagulation therapy after total knee arthroplasty in Korea.
Incidence of venous thromboembolism using 64 channel multidetector row computed tomography-indirect venography and anti-coagulation therapy after total knee arthroplasty in Korea.
复制标题
DOI：
10.5792/ksrr.2012.24.1.19
复制
发表时间：
2012-03
影响因子：
3.1
通讯作者：
Kyung HS
中科院分区：
文献类型：
--
作者：
Park KH;Cheon SH;Lee JH;Kyung HS
本研究使用多排计算机断层扫描-间接静脉造影（MDCT-间接静脉造影）评价了全膝关节置换术（TKA）后静脉血栓栓塞（VTE）的发生率，并评估了抗凝治疗的疗效。我们入组了118例患者，共126例TKA。患者的平均年龄为68.4岁。我们使用64通道MDCT-间接静脉造影检测静脉血栓栓塞。我们根据MDCT间接静脉造影的结果选择性地治疗近端深静脉血栓形成（DVT）或肺血栓栓塞（PTE）病例。3个月后，我们使用随访MDCT-间接静脉造影重新评估了VTE的变化。35.7%的患者发生了静脉血栓栓塞。22.2%为单纯DVT，其中近端DVT 8例，远端DVT 20例。4.8%的患者发生了PTE而没有DVT，8.7%的患者合并DVT和PTE。所有PTE患者均无症状，但4例DVT患者有腿部肿胀体征。20例患者经抗凝治疗后，16例完全缓解，3例好转，1例出现新发远端DVT。韩国初次TKA后VTE的发生率为35.7%。此外，对近端DVT和PTE患者进行抗凝治疗可能是预防致命性PTE发生的有效方法。
This study evaluated the incidence of a venous thromboembolism (VTE) after total knee arthroplasty (TKA) using multidetector row computed tomography-indirect venography (MDCT-indirect venography) and assessed the efficacy of anti-coagulation therapy. We enrolled 118 patients with 126 cases of TKA. The average age of the patients was 68.4 years. We used 64 channel MDCT-indirect venography for the detection of VTE. We treated selectively proximal deep vein thrombosis (DVT) or pulmonary thromboembolism (PTE) cases according to the results of MDCT-indirect venography. We re-evaluated the change in VTE using follow-up MDCT-indirect venography after 3 months. We identified VTE in 35.7%. DVT only was identified in 22.2% including 8 cases of proximal DVT and 20 cases of distal DVT. PTE without DVT was identified in 4.8%, and combined DVT and PTE in 8.7%. All patients with PTE were asymptomatic, but 4 DVT patients had signs of leg swelling. After anti-coagulation therapy, 20 patients showed complete resolution in 16 cases, improvement in 3 cases and one case showed a new distal DVT. The incidence of VTE after primary TKA was 35.7% in Korea. Furthermore, anti-coagulation therapy for proximal DVT and PTE patients may be a useful method for preventing the occurrence of a fatal PTE.