한국인에서 슬관절 전치환술 시 정맥혈전색전증의 예방적 치료

초록

Purpose To evaluate the effects and problems of venous thromboembolism (VTE) prophylaxis with a reduced dosage and administration period in Korean total knee arthroplasty (TKA) patients. Materials and Methods We analyzed 135 consecutive TKA patients with three different VTE prophylaxis regimens. Group dalteparin-aspirin (DA) injected dalteparin for the first 2 days, followed by taking aspirin for the next 5 days, Group aspirin (A) was on aspirin and Group dalteparin (D) on dalteparin 7 days postoperatively. We evaluated the incidence of VTE and safety among the 3 groups. Results Symptomatic deep vein thrombosis was detected in 4 cases (Group DA: 2, Group A: 1, Group D: 1). Pulmonary embolism (PE) was found in 1 case in each group with no fatal PE. Although no major bleeding complications were seen, minor bleeding incidents were detected in 14 cases (Group DA: 2, Group A: 1, Group D: 11), which was significant in Group D. No significant differences were observed in perioperative blood loss, effusion in the knee joint, thigh swelling or oozing on the wound area among the groups except thigh bruising, which developed more frequently in group D. Conclusion The reduced dosage and administration period of VTE prophylactic medicine combined with mechanical prophylaxis for Korean TKA patients showed no fatal PE, but some minor bleeding incidents frequently developed with 7 days of dalteparin injections. We need to adjust the dosage and duration of prophylactic medication deliberately for Korean TKA patients, considering prophylaxis effectiveness and bleeding complication risks.

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