Huyết khối sau phẫu thuật là một biến chứng có khả năng gây chết người. Hãy chẩn đoán của tháng khó khăn, như những dấu hiệu và triệu chứng lâm sàng cổ điển thường vắng mặt, làm cho một chỉ số cao của sự nghi ngờ cho cấp thiết chẩn đoán. IS liệu pháp chống đông có hiệu quả trong giảm bệnh tật và tử vong | Thromboembolism After Hip and Knee Arthroplasty Diagnosis and Treatment Craig J. Della Valle MD David J. Steiger MD and Paul E. Di Cesare MD Abstract Postoperative thromboembolism is a potentially lethal complication. Its diagnosis may be difficult as the classic clinical signs and symptoms are often absent making a high index of suspicion imperative for diagnosis. Anticoagulant therapy is effective in reducing morbidity and mortality due to thromboembolism but is associated with a substantial rate of bleeding complications in the immediate postoperative period. Inferior vena cava filters constitute an alternative to anticoagulant therapy but are also associated with a substantial complication rate. The appropriate use of diagnostic tests combined with clinical suspicion can guide the orthopaedic surgeon in deciding which patients require treatment for thromboembolism. J Am Acad Orthop Surg 1998 6 327-336 Thromboembolism is the most frequent serious complication following major orthopaedic surgery. Without prophylaxis deep venous thrombosis DVT develops in approximately 50 of patients who undergo elective total hip arthroplasty and pulmonary emboli develop in as many as 20 2 of whom suffer fatal pulmonary embolism PE .1 Patients undergoing total knee arthroplasty are at especially high risk for DVT with rates reaching 84 in the absence of prophylaxis however lower rates of PE 7 and death have been Despite modern prophylaxis the incidence of venous thrombosis in elective total joint arthroplasty is still high with venographically confirmed proximal DVT developing in 2 to 12 of patients. The high incidence of DVT and subsequent PE makes it the most common cause of death following total joint arthroplasty. Patients are predisposed to venous thrombosis if they fulfill the elements of VirchowÕs triad venous stasis endothelial injury and hypercoagulability. Venous stasis occurs secondary to long periods of immobilization in the operating room and delayed .
