梅-特纳综合征是全髋关节置换术中深部静脉血栓形成的主要风险因素吗?

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
Accounts of Chemical Research Pub Date : 2024-02-01 Epub Date: 2024-01-15 DOI:10.4055/cios23128
Chaemoon Lim, Young Ho Roh, Dae Whan Kim, Kwang Woo Nam
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引用次数: 0

摘要

背景:梅-特纳综合征(MTS)是一种髂静脉受压综合征,与术后深静脉血栓形成(DVT)有关,其原因是左侧髂静脉长期受到右侧或左侧髂总动脉对腰椎的压迫。MTS作为全髋关节置换术(THA)后深静脉血栓形成的风险因素还不为人所知。我们评估了全髋关节置换术后深静脉血栓的发生率,并分析了 MTS 是否是全髋关节置换术后深静脉血栓的危险因素。我们假设 MTS 与 THA 术后发生深静脉血栓的风险增加有关:确定了 2009 年 1 月 1 日至 2017 年 1 月 12 日期间接受 THA 的所有年龄大于 65 岁的患者。其中,对术后出现下肢深静脉血栓的患者进行了病历资料回顾。通过下肢计算机断层扫描(CT)血管造影确诊为 MTS。我们对 MTS 患者的人口统计学数据、症状、诊断和治疗进行了分析:共有 492 名年龄大于 65 岁、接受过 THA 手术的患者入选。其中,5 名患者(1.0%)术后出现下肢深静脉血栓。经过下肢 CT 血管造影检查,5 名深静脉血栓患者中有 4 名(80%)被确认为患有 MTS。所有 MTS 患者均为女性,表现为左腿疼痛和肿胀。所有 MTS 患者都接受了全身抗凝、抽吸血栓切除术和经皮腔内血管成形术治疗。所有患者的血栓均已完全溶解:结论:如果延迟诊断 MTS,发病率和死亡率都会显著增加。骨科医生应该意识到 MTS 是 THA 术后深静脉血栓形成的一个危险因素。此外,应考虑在术前通过双工超声或 CT 血管造影进行评估,以确认 MTS。因此,本研究被认为对 THA 术后 MTS 的早期诊断和适当治疗具有足够的临床价值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Is the May-Thurner Syndrome a Major Risk Factor for Deep Vein Thrombosis in Total Hip Arthroplasty?

Background: May-Thurner syndrome (MTS) is iliac vein compression syndrome associated with postoperative deep vein thrombosis (DVT) resulting from chronic compression of the left iliac vein against lumbar vertebrae by the overlying right or left common iliac artery. MTS is not well known as a risk factor for DVT after total hip arthroplasty (THA). We evaluated the incidence of DVT after THA and analyzed if the MTS is a risk factor for DVT after THA. We hypothesized that MTS would be associated with an increased risk of developing DVT after THA.

Methods: All patients > 65 years of age who underwent THA between January 1, 2009, and January 12, 2017, were identified. Among them, the patients who presented for postoperative DVT of the lower extremity were reviewed with medical record data. MTS was diagnosed with computed tomography (CT) angiography of the lower extremity. We analyzed the demographic data, symptoms, diagnoses, and treatment of MTS patients.

Results: A total of 492 consecutive patients aged > 65 years who underwent operation for THA were enrolled. Among them, 5 patients (1.0%) presented for postoperative DVT of the lower extremity. After reviewing the CT angiography of the lower extremity, 4 out of 5 DVT patients (80%) were identified as having MTS. All MTS patients were female and presented with pain and swelling of the left leg. All MTS patients were treated with systemic anticoagulation, aspiration thrombectomy, and percutaneous transluminal angioplasty. Complete resolution of thrombus was observed in all patients.

Conclusions: If the diagnosis of MTS is delayed, the morbidity and mortality rates are significantly increased. Orthopedic surgeons should be aware of MTS as a risk factor for DVT after THA. Moreover, preoperative evaluation with duplex sonography or CT angiography to confirm MTS should be considered. In this regard, this study is considered to have sufficient clinical value for early diagnosis and appropriate treatment of MTS after THA.

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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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