Journal of the Korean Orthopaedic Association (대한정형외과학회지)

Korean Orthopaedic Association (대한정형외과학회)
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Availability of D-dimer Test for the Diagnosis of Deep Vein Thrombosis after Total Knee Arthroplasty

슬관절 전 치환술 후 심부 정맥 혈전증의 발생에 대해 D-dimer 검사의 유용성

Kim, Young-Jin;Song, Eun-Kyoo;Seon, Jong-Keun;Park, Sang-Jin;Cho, Seong-Beom;Cho, Yong-Jin;Hur, Chang-Ich
김영진;송은규;선종근;박상진;조성범;조용진;허창익

  • Published : 20070800
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Abstract

Purpose: To investigate the prevalence of deep vein thrombosis (DVT) after Total knee arthroplasty (TKA) and evaluate the availability of D-dimer test for the diagnosis of DVT after TKA. Materials and Methods: From April 2006 to July 2006, 140 consecutive patients, who had degenerative osteoarthritic knees and underwent primary total knee arthroplasty, were enrolled in this study. General and hematological risk factors were compared between DVT positive and negative patients. D-dimer level was checked preoperatively, and at 1, 7 and 14 days after surgery. A diagnosis of DVT was established by computed tomography venography. Results: DVT was found in 48 (34%) patients and only 5 (10.4%) showed symptoms of DVT. Regarding the risk factors, only obesity was significantly associated with an increased incidence of DVT (p=0.049). Seven days after surgery, the average D-dimer level in the DVT positive and negative patients was 4.90 mg/L and 3.12 mg/L, respectively (p=0.000). Conclusion: In our study patients, the incidence of symptomatic DVT was lower than in the Western population. We recommend obesity, clinical symptoms and D-dimer value at 7 days after surgery as a valuable screening tests for detecting DVT.

목 적: 슬관절 전 치환술 후에 발생하는 증상이 있는 심부 정맥 혈전증의 빈도를 알아보고 D-dimer 검사의 유용성에 대해 알아보고자 한다. 대상 및 방법: 2006년 4월부터 2006년 7월까지 퇴행성 슬관절염으로 슬관절 전 치환술을 시행한 140명의 환자를 전향적으로 조사하였다. 알려진 위험인자들에 대해 평가하였으며, D-dimer 검사는 술 전 및 술 후 1, 7, 14일째 시행하였다. 술 후 7일째 CT 정맥 조영술을 시행하여 혈전증 유무를 조사하였다. 결 과: 총 48명 (34%)에서 심부 정맥 혈전증이 발생하였으며, 이 중 증상을 호소한 경우는 5명(10.4%)이었다. 위험인자들 중 심부 정맥 혈전증이 발생한 군과 발생하지 않은 군 간의 유의한 차이를 보이는 경우는 비만도 뿐이었으며, D-dimer 검사상 두 군 간의 유의한 차이를 보이는 경우는 술 후 7일째였으며 각각 평균 4.90mg/L와 3.12 mg/L였다. 결 론: 증상을 보이는 심부 정맥 혈전증의 빈도는 높지 않았다. 비만도, 임상증상 및 술 후 7일째 측정한 D-dimer 검사를 심부 정맥 혈전증의 선별검사로 이용할 수 있으리라 사료된다.

Keywords

References

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