D-dimer for Early Diagnosis of Pulmonary Thromboembolism after Total Knee Arthroplasty

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概要

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• Objective: The aim of this study was to evaluate the usefulness of D-dimer for the early diagnosis of deep vein thrombosis (DVT) and pulmonary thromboembolism (PTE), after total knee arthroplasty (TKA) .<BR>Material and Methods: TKA was performed in seventeen patients with osteoarthritis. The patients were 5 males (5 knees) and 12 females (13 knees) with a mean age of 75 years (range 63-86 years) at the time of surgery. We performed pulmonary perfusion scintigraphy to diagnose PTE on the same day after the operations. Four days after surgery we performed ultrasound and venography on the lower extremities to test for DVT. On the 1st, 4th and 7th days after TKA, we checked the D-dimer values.<BR>Results: We divided the patients into two group: 1) Three severe thromboembolism cases; patients who had PTE or wide DVT which required an IVC filter. 2) All other fifteen, mild cases. The mean D-dimer value for severe thromboembolism cases was 22.9±8.8μg/ml on the 1st day, and 27.4±10.5 μg/ml on the 4th day. On the other hand, the mean D-dimer value for the mild cases was 14.6±10.1μg/ml on the 1st day, and 7.8±3.1μg/ml on the 4th day.<BR>Conclusion: The D-dimer levels of patients who had PTE or severe DVT were high on the 1st day after operation compared to the milder cases. In addition, those values became higher on the 4th day, whereas they became lower in the milder cases. We think the comparison of the 1st day D-dimer value and that of the 4th day was useful for early diagnosis of PTE or severe DVT cases.

• 日本関節病学会の論文

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