膝关节镜术后静脉血栓形成危险因素的研究进展

Research progress in risk factors for venous thrombosis after knee arthroscopy

静脉血栓栓塞（VTE）是髋膝关节置换手术及很多较大骨科手术术后常见的并发症。VTE主要包括深静脉血栓（DVT）和肺栓塞（PE）。症状性PE很可能会危及患者生命，造成不可逆的严重后果，而随着静脉的回流，DVT也可能随时脱落形成新的PE。对于骨科大手术后VTE的预防已经受到全世界学者的高度重视。但膝关节镜术后VTE问题尚未得到临床医师的广泛关注。虽然膝关节镜术后VTE的发生率较低，且各研究间差异较大（0．42％～17．9％），学者之间也对术后是否常规抗凝治疗观点不一，但是因为每年膝关节镜手术的数量非常庞大，膝关节镜术后VTE的发生率也是不容忽视的。基于上述原因，一部分学者提出对膝关节镜手术患者进行分层，对于术后VTE发生风险较高的患者给予抗凝治疗。可见膝关节镜术后VTE的危险因素可能对患者的临床治疗产生影响。笔者综述可能影响其术后VTE形成的相关危险因素，为术后抗凝治疗提供参考。

Venous thromboembolism （VTE） is a common complication of hip and knee arthroplasty and of many major orthopedic surgeries. VTE mainly includes two aspects, ie, deep vein thrombosis （DVT） and pulmonary embolism （PE）. Symptomatic PE is likely to endanger patients＇ life, resulting in irreversible severe consequences. With the return of venous blood, DVT may also fall off at any time, forming a new PE. Therefore, the prevention of VTE in large orthopedic surgeries has been highly valued by scholars worldwide. However, the problem of VTE after arthroscopic surgery has not drawn much attention from clinicians. Researchers have not reached a consensus on whether routine anticoagulation therapy is required after surgery because of VTE＇s low incidence and discrepancy among various studies （0.42% -17.9% ）. With a large number of knee arthroscopy being performed per year, the postoperative VTE incidence can not be ignored. For these reasons, some scholars have suggested that patients after knee arthroscopy should be stratified and that patients with a higher risk of postoperative VTE need to be given anticoagulant therapy. Risk factors for VTE after knee arthroscopy may have effects on the clinical treatment of patients. Therefore, a review of the literature to explore the possible risk factors for postoperative VTE was conducted.