臨床整形外科49巻12号

2014年12月発行

臨床経験

大腿骨近位部骨折における深部静脈血栓症の術前発生—下肢静脈超音波検査を用いて

著者： 中島佳子¹ 横井直幸¹ 吉田綾¹ 渡邉寛²

所属機関： ¹取手北相馬保健医療センター医師会病院整形外科 ²取手北相馬保健医療センター医師会病院循環器科

ページ範囲：P.1119 - P.1123

　背景：大腿骨近位部骨折術前の深部静脈血栓症(DVT)発生例の患者背景を検討した．

　対象と方法：64例で術前の下肢静脈超音波検査を行った．

　結果：DVTは64例中17例(26.6％)で観察され，近位型5例，遠位型12例であった．近位型DVTは，受傷から2日以内に超音波検査を受けた症例では29例中1例(3.4％)，受傷から3日以降に超音波を受けた症例では35人例中4例(11.4％)で発生し，受傷後3日以降での近位型DVTにおいてより高い発生率の傾向を示唆した．

　まとめ：本骨折では，受傷後早期の手術が推奨されているが，本研究では受傷後早期のDVT発生が確認され，下肢静脈超音波検査による術前の積極的な検索が必要と考えた．

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