在患有V因子Leiden的患者中进行全关节整形手术:与静脉血栓塞栓事件隔离的高风险
Joshua G Sanchez1, Will M Jiang1, Meera M Dhodapkar1
1Yale Department of Orthopaedics and Rehabilitation, New Haven, Connecticut.
The Journal of arthroplasty
|June 5, 2024
概括
接受关节整形手术 (THA) 的V因子Leiden (FVL) 患者面临着明显更高的静脉血栓塞栓症 (VTE) 风险. 强大的化学预防可以减轻这些风险,而不会增加出血事件.
科学领域:
- 整形外科手术 整形外科手术
- 血液学 血液学 血液学
- 药理学 药理学是指药理学的学科.
背景情况:
- 全关节整形术 (THA) 是一种常见的骨科手术.
- 莱顿V因子 (FVL) 是一种遗传性血栓性疾病,增加了静脉血栓栓塞 (VTE) 的风险.
- 像FVL这样的先前存在的并发症需要在THA患者中进行谨慎的管理.
研究的目的:
- 在接受THA的FVL患者中量化VTE风险.
- 在这个人群中评估VTE化学预防剂的疗效.
- 评估其他术后不良事件和FVL患者的植入物存活率.
主要方法:
- 对544,022名成人THA患者 (2010-2021) 的回顾性分析.
- 1,131名FVL患者和4,519名非FVL患者的匹配队列.
- 针对90天并发症和5年植入物存活率的多变量分析;化学预防剂使用和结果的评估.
主要成果:
- 在FVL患者中,90天DVT (OR=9.20) 和PE (OR=6.89) 的几率明显更高.
- FVL与严重不良事件的几率增加有关 (OR=4.74).
- 更强大的化学预防药物 (华法林,肝素,DOAC) 降低了VTE风险,但没有增加出血.
结论:
- 在THA之后,FVL显著增加了VTE风险.
- 在FVL患者中,其他不良事件和重新手术率并没有增加.
- 化学预防剂对于在接受THA的FVL患者中管理VTE风险至关重要.
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