孤立性小腿肌间静脉血栓在关节置换的意义  

Significance of isolated calf intermuscular venous thrombosis in major joint arthroplasty

作　　者：戎圣炜 李婧[1] 包良笑[1] 史占军[1] 张洋[1] RONG Sheng-wei;LI Jing;BAO Liang-xiao;SHI Zhan-jun;ZHANG Yang(Department of Bone and Joint Surgery,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China)

机构地区：[1]南方医科大学南方医院关节与骨病外科,广东广州510515

出　　处：《中国矫形外科杂志》2021年第9期818-821,共4页Orthopedic Journal of China

基　　金：国家自然科学基金面上项目(编号:81772407);国家自然科学基金项目(编号:81660374,81760404);兵团中青年科技创新项目(编号:2016BC001)。

摘　　要：随着静脉多普勒超声技术的成熟与普及,孤立性小腿肌间静脉血栓(isolated calf muscular vein thrombosis,ICMVT)在髋膝关节置换患者围术期中的检出率愈来愈高。然而,目前国内外对其临床意义以及治疗方案尚未达成共识。近年来有学者认为ICMVT可能会向近端深静脉扩展,甚至并发肺栓塞从而造成严重的临床后果,并建议对ICMVT行抗凝治疗。亦有研究认为ICMVT属于良性血栓,并且给出了相关的推荐治疗方案如连续影像学监测,物理预防等。本文系统性回顾了2000年1月~2019年12月所发表的证据等级较高的相关研究并对其进行对比与分析,以期加深医务工作者对ICMVT的认识,并探讨可供参考的ICMVT治疗方案。With the maturity and popularization of venous Doppler ultrasound technology,the detection rate of isolated calf muscular vein thrombosis(ICMVT)is getting higher and higher in perioperative period of hip and knee joint replacement.However,there is no consensus on clinical significance and treatment options of ICMVT at home and abroad.In recent years,some scholars believe that ICMVT may extend to the proximal deep veins,and even cause pulmonary embolism,which may lead to serious clinical consequences,and recommend anticoagulation therapy for ICMVT.There are also studies that believe ICMVT is a benign thrombus,and recommended treatment options such as continuous imaging monitoring,physical prevention,etc.are given.This article systematically reviews the relevant studies with higher levels of evidence published during the period from January 2000 to December 2019,and compares and analyzes them with a view to deepening medical workers'understanding of ICMVT,and discussing an ICMVT treatment plan that can be used as a reference.

关 键 词：孤立性小腿肌间静脉血栓 下肢深静脉血栓形成 抗凝 关节置换 

分 类 号：R687.4[医药卫生—骨科学]