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中国防痨杂志 ›› 2018, Vol. 40 ›› Issue (5): 490-493.doi: 10.3969/j.issn.1000-6621.2018.05.010

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  1. 300350 天津市海河医院
  • 收稿日期:2018-01-30 出版日期:2018-05-10 发布日期:2018-06-12
  • 通信作者: 张文龙

A prospective study on occurrence of venous thromboembolism after spinal tuberculosis surgery

Jian-dong CHEN,Chen ZHANG,Rui-rui MIAO,Wen-long ZHANG()   

  1. Haihe Hospital of Tianjin, Tianjin 300350, China
  • Received:2018-01-30 Online:2018-05-10 Published:2018-06-12
  • Contact: Wen-long ZHANG


目的 通过分析脊柱结核术后静脉血栓栓塞(venous thromboembolism,VTE)的发生率,探讨围手术期采取相关措施预防VTE的必要性。方法 选取2012年5月至2017年8月在天津市海河医院骨科由同一组医师进行手术的146例未进行抗凝治疗的脊柱结核患者,术前进行血常规、凝血指标及双下肢静脉彩色多普勒超声检查,术后采用彩色多普勒超声对双下肢静脉进行复查,并随访3个月。结果 术前未发现深静脉血栓(deep venous thrombosis,DVT)形成的146例行脊柱结核手术患者中,术后11例发生DVT(发生率7.53%),无肺栓塞(pulmonary embolism,PE)发生。所有术后7~10d发现DVT的患者均为小腿肌间静脉血栓,位于膝关节以下,无明显临床症状,未进行相关治疗。术后3个月采用彩色多普勒超声复查时DVT消失。结论 脊柱结核围手术期不采用抗凝预防措施的情况下,DVT有较高的自然发生率;所有发生DVT的患者并未出现严重后果,脊柱结核围手术期无需常规药物预防DVT。

关键词: 结核, 脊柱, 外科手术, 静脉血栓形成, 围手术期医护, 预防用药


Objective To investigate the incidence of deep venous thromboembolism (DVT) after the operation of the patients with spinal tuberculosis, and to explore the necessity of adopting relevant measures to prevent occurrence of DVT during perioperative period.Methods This study was conducted in 146 patients with spinal tuberculosis who underwent surgery from the same group of physicians and did not receive anticoagulation from May 2012 to August 2017 in Haihe Hospital. Preoperative blood routine examination, coagulation index and double lower limb venous color Doppler ultrasonography were performed; after the operation, the double lower extremity venous color Doppler ultrasound were repeated, and follow-up for 3 months.Results Among the 146 patients who were confirmed to have no DVT before operation, the DVT was found in 11 cases and no pulmonary embolism (PE) cases were diagnosed. The spontaneous incidence of DVT after spinal tuberculosis surgery was 7.53%. All patients with postoperative DVT after 7-10 days of operation had the calf muscle venous thrombosis which located in the far beyond the knee. The patients had no obvious clinical symptoms and did not receive related treatment. The DVT disappeared after 3 months of review of doppler ultrasound.Conclusion In the perioperative period of spinal tuberculosis operation, DVT have a higher natural incidence without anticoagulation. All patients with DVT do not have serious consequences, and the perioperative period of spinal tuberculosis do not need conventional drugs to prevent DVT.

Key words: Tuberculosis, spinal, Surgical procedure, Venous thrombosis, Perioperative care, Protective agents