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首页> 外文期刊>Current sports medicine reports. >Venous Thromboembolic Event After Elective Anterior Cruciate Ligament Reconstruction: A Case Report
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Venous Thromboembolic Event After Elective Anterior Cruciate Ligament Reconstruction: A Case Report

机译：静脉血栓栓塞发生选修前十字韧带重建 - 案例报告

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Venous thromboembolism (VTE) events are considered rare in elective arthroscopy; however, 47 studies in a systematic review identify the incidence of deep vein thrombosis (DVT) without thromboprophylaxis to be 9.9%, of which 2.1% are symptomatic (1,2). Deep vein thrombosis may present with varying clinical signs and not all are symptomatic. In fact, 2 to 4 yr after major orthopedic surgery, 24% of lower extremities with asymptomatic DVT have been shown to develop postphlebitic syndrome (1). Common risk factors for DVT in a younger adult population include obesity, smoking, use of oral contraceptives, family history of DVT and complications of an occlusive thrombus. Operative risks, such as tourniquet use for longer than 60 min during anterior cruciate ligament (ACL) reconstruction, may increase rates of DVT (1,3-6). Postoperative risks such as knee immobilization also increase DVT rates. Risk factors that can predispose a patient to VTE are listed in Table 1 (4,5,7-15). Common clinical signs of DVT include leg swelling, redness, elevated skin temperature, and a positive Homan's sign. In terms of diagnostic imaging, Sun et al. reported sensitivity and specificity of ultrasonography to be 30% to 85% and 93% to 100%, respectively (2). While venography remains the gold standard for diagnosis, it is unlikely to be performed due to cost and the invasive-ness of the study (2,16,17). Postoperative risks, such as knee immobilization, also increase DVT rates. Recognizing the potential for and complications of a DVT leads to a discussion of chemoprophylaxis.
机译：静脉血栓栓塞（VTE）事件被认为是罕见的选择性关节镜概念;然而，系统评论中的47项研究将无凝血性血栓形成（DVT）的发病率为9.9％，其中2.1％是症状（1,2）。深静脉血栓形成可能存在不同的临床症状，而不是所有的症状。事实上，主要骨科手术后2至4年，已显示24％的患有无症状DVT的下肢进行突破性综合征（1）。较年轻的成年人口DVT的常见风险因素包括肥胖，吸烟，口服避孕药，DVT家族史和闭塞血栓的并发症。在前令韧带（ACL）重建期间，止血带使用的止血带使用的速度范围超过60分钟，可能会增加DVT（1,3-6）的速率。膝关节固定化的术后风险也增加了DVT率。表1（4,5,7-15）中列出了可以将患者倾向于VTE的危险因素。 DVT的常见临床迹象包括腿部肿胀，发红，瘦弱的皮肤温度，以及积极的HONAN的标志。在诊断成像方面，Sun等人。报告超声检查的敏感性和特异性分别为30％至85％，分别为93％至100％（2）。虽然静脉造影仍然是诊断的金标准，但由于成本和研究的侵入性（2,16,17），不太可能进行。术后风险，如膝关节固定，也增加了DVT率。认识到DVT的潜力和并发症导致培养化学脑膜讨论。

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