Deep vein thrombosis prophylaxis in patients who undergo knee arthroscopy: a systematic review.

Udit Dave, Emma G Lewis, Victoria K Ierulli, Shreya M Saraf, Mary K Mulcahey
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Abstract

Background: Knee arthroscopy is one of the most common procedures performed by orthopedic surgeons. A potentially life-threatening complication following this procedure is deep vein thrombosis (DVT). DVT prophylaxis can be obtained both mechanically (e.g., compression stockings) and chemically (e.g., aspirin, anticoagulants, and factor Xa inhibitors). Currently, there is no standardized guideline for DVT prophylaxis following knee arthroscopy. The purpose of this systematic review was to summarize how DVT prophylaxis is employed for patients who undergo knee arthroscopy.

Methods: PubMed, Embase, and Cochrane Library were searched for studies published after 1998 according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were included if they evaluated DVT prophylaxis regimens in patients of any age who underwent knee arthroscopy. Studies not written in English, that analyzed animals or cadavers, that did not directly evaluate patients undergoing knee arthroscopy, or that did not address DVT prophylaxis were excluded.

Results: The initial search identified 300 studies, 15 of which were included. These 15 studies examined methods of DVT prophylaxis, including compression stockings (2 of 18; 11%), aspirin (1 of 18; 6%), factor Xa inhibitors (2 of 18; 11%), low-molecular-weight heparin (12 of 18; 67%), and neuromuscular electrical stimulation (1 of 18; 6%). Overall, 7 of 15 (47%) studies recommended DVT prophylaxis in all patients, and 3 (20%) studies supported its use for high-risk patients. Five (33%) studies did not support DVT prophylaxis, citing low incidence of postoperative DVT.

Conclusions: Compression stockings, aspirin, factor Xa inhibitors, and low-molecular-weight heparin (LMWH) were identified as possible options for DVT prophylaxis in patients undergoing knee arthroscopy. For high-risk knee arthroscopy patients, factor Xa inhibitors and LMWH drugs are appropriate for DVT prophylaxis. Level of evidence Level III, systematic review of level I-III studies.

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在接受膝关节镜检查的患者中预防深静脉血栓形成:一项系统综述。
背景:膝关节镜检查是骨科医生最常用的手术之一。深静脉血栓形成(DVT)是该手术后潜在的危及生命的并发症。深静脉血栓预防可以通过机械方法(如压缩袜)和化学方法(如阿司匹林、抗凝血剂和Xa因子抑制剂)两种方法获得。目前,对于膝关节镜术后DVT的预防尚无标准化的指南。本系统综述的目的是总结如何预防深静脉血栓形成的患者接受膝关节镜检查。方法:根据系统评价和荟萃分析(PRISMA)指南,检索PubMed、Embase和Cochrane图书馆1998年以后发表的研究。研究包括评估任何年龄接受膝关节镜检查的患者的深静脉血栓预防方案。非英文研究、分析动物或尸体的研究、未直接评估接受膝关节镜检查的患者的研究、或未涉及深静脉血栓预防的研究均被排除。结果:最初的检索确定了300项研究,其中15项被纳入。这15项研究检查了预防深静脉血栓的方法,包括压缩袜(18项中的2项;11%),阿司匹林(1 / 18;6%), Xa因子抑制剂(2 / 18;11%),低分子量肝素(12 / 18;67%)和神经肌肉电刺激(1 / 18;6%)。总体而言,15项研究中有7项(47%)建议对所有患者进行深静脉血栓预防,3项(20%)研究支持对高危患者使用深静脉血栓预防。五项(33%)研究不支持深静脉血栓预防,理由是术后深静脉血栓发生率低。结论:加压袜、阿司匹林、Xa因子抑制剂和低分子肝素(LMWH)被确定为膝关节镜检查患者预防DVT的可能选择。对于高危膝关节镜患者,Xa因子抑制剂和低分子肝素药物适合用于DVT预防。证据等级III级,对I-III级研究进行系统评价。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
6.50
自引率
0.00%
发文量
42
审稿时长
19 weeks
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