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ID 53556
JaLCDOI
フルテキストURL
Thumnail 69_4_205.pdf 1.89 MB
著者
Okada, Yoshiki Department of Orthopaedic Surgery, Takasago Municipal Hospital
Endo, Hirosuke Department of Medical Materials for Musculoskeletal Reconstruction, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Mitani, Shigeru Department of Orthopaedic Surgery, Kawasaki Medical School
Fujiwara, Kazuo Intelligent Orthopaedic Systems, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Tetsunaga, Tomonori Department of Orthopaedic Surgery, Okayama University Hospital
Kagawa, Yohei Department of Orthopaedic Surgery, Okayama University Hospital
Fujii, Yosuke Department of Orthopaedic Surgery, Okayama University Hospital
Kunisada, Toshiyuki Department of Orthopaedic Surgery, Okayama University Hospital
Ozaki, Toshifumi Department of Orthopaedic Surgery, Okayama University Hospital
抄録
Total hip arthroplasty (THA) is the most effective treatment for advanced or end-stage hip osteoarthritis. However, venous thromboembolism (VTE) remains one of its unresolved complications. We reviewed the records of 322 patients undergoing primary THA and investigated the efficacy of anticoagulant prophylaxis for VTE. Our study cohort consisted of 60 patients who received no anticoagulants, 100 patients who received a factor Xa inhibitor (fondaparinux), 100 patients who received low molecular weight heparin (enoxaparin), and 62 patients who selectively received no anticoagulant prophylaxis due to perioperative bleeding, weight, and/or hemoglobin concentration. Enhanced 64-slice multidetector row computed tomography was performed postoperatively for 7 days in all cases. The incidence of VTE in the four groups was 15オ, 9.0オ, 6.0オ, and 6.4オ, respectively. The incidence of VTE was significantly lower in the groups receiving anticoagulant prophylaxis and the group selectively receiving no anticoagulant prophylaxis than in the group receiving no anticoagulants. Complications of fondaparinux therapy included hepatic dysfunction in 4 cases (4.0オ), minor bleeding in 2 cases (2.0オ), persistent wound drainage in 3 cases (3.0オ), and eruption in 1 case (1.0オ). The complications of enoxaparin therapy were persistent wound drainage in 1 case (1.0オ) and progression of anemia in 1 case (1.0オ). The incidence of VTE was low in patients who selectively received no anticoagulant prophylaxis, so we conclude that anticoagulant prophylaxis should be used selectively in THA cases.
キーワード
total hip arthroplasty
venous thromboembolism
anticoagulant prophylaxis
complications
Amo Type
Original Article
発行日
2015-08
出版物タイトル
Acta Medica Okayama
69巻
4号
出版者
Okayama University Medical School
開始ページ
205
終了ページ
212
ISSN
0386-300X
NCID
AA00508441
資料タイプ
学術雑誌論文
言語
English
著作権者
CopyrightⒸ 2015 by Okayama University Medical School
論文のバージョン
publisher
査読
有り
PubMed ID
Web of Sience KeyUT
関連URL
http://doi.org/10.18926/AMO/53680