替代疗法是否会在全或膝关节关节整形术后增加血栓形成的风险?
Andrew Ni1, Eric Cal1, Victor Martinez1
1Department of Orthopaedic Surgery, University of Texas Health San Antonio, San Antonio, Texas.
The Journal of arthroplasty
|November 23, 2025
概括
替代疗法 (TRT) 增加了膝关节置换后的肺栓塞风险,但不是部置换. 整形外科医生应考虑在接受全关节整形手术的患者中TRT风险.
科学领域:
- 整形外科手术 整形外科手术
- 内分泌学 在内分泌学.
- 心血管健康 心血管健康
背景情况:
- 丸激素是一种原血栓激素.
- 外源性对静脉血栓栓塞事件 (VTE) 在全关节整形术 (TJA) 后的影响尚不清楚.
- 这项研究考察了替代疗法 (TRT) 与部和膝关节置换术后静脉瘤风险之间的联系.
研究的目的:
- 调查TRT和VTE风险之间的关联.
- 在接受初级关节整形手术 (THA) 和全膝关节整形手术 (TKA) 的患者中分析VTE发病率.
主要方法:
- 使用国家注册表 (2005-2025) 进行回顾性,匹配的队列研究.
- 包括640,219名患者 (265,477名THA,374,742名TKA) 在内.
- 通过TRT分层的患者在TJA后三个月内使用;在TJA后三个月内分析深静脉血栓塞 (DVT) 和肺栓塞 (PE).
主要成果:
- 在TRT (OR=1.45,P=0.029) 的TKA患者中观察到PE率的显著增加.
- 在接受TRT的TKA患者中,DVT发生率没有显著差异 (OR=1.27,P=0.073).
- 在TRT的THA患者中,没有发现PE或DVT率的显著差异.
结论:
- 在TKA之后,TRT与更高的PE风险有关,但不是DVT.
- 在THA.之后,没有发现TRT和VTE之间的显著关联.
- 整形外科医生必须意识到与TRT相关的风险,特别是随着关节塑形术患者使用的增加.
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