変形性膝関節症に対する人工膝関節全置換術において予防的抗凝固療法と総出血量・輸血回避率の関係

The Relationship between Blood Loss,Rate of Avoidance of Allogenic Blood Transfusions and Preventive Anticoagulant Therapy after Total Knee Arthroplasty for Osteoarthritis

　深部静脈血栓症(DVT)に対する人工膝関節全置換術(TKA)術後の予防的抗凝固療法の有無により，術後出血量・輸血回避率・DVT症例数に違いがあるか検討した．対象は当院で初回手術を受けた変形性膝関節症(OA膝)74例である．術後に未分画ヘパリン，または低分子ヘパリン投与後にワーファリンを引き続き3カ月投与したグループを抗凝固療法あり群(40例)，それらを投与せず弾性ストッキングなどで予防したグループを抗凝固療法なし群(34例)とした．2群間で年齢，性別，総出血量，輸血回避率，DVT治療症例数について比較を行ったが，全項目において有意差はなかった．

　We compared blood loss, rate of avoidance of allogeneic blood transfusion, and the number of deep vein thrombosis (DVTs) in 74 patients after total knee arthroplasty according to whether they had received preventive anticoagulant therapy by retrospectively reviewing the clinical records for the 40 knees of 40 patients in an anticoagulant therapy group and the 34 knees of 34 patients in the control group.　In the anticoagulant therapy group, warfarin was administered for 3 months continuously after prescription unfractionated heparin or low molecule heparin after total knee arthroplasty.　The differences in blood loss, rates of avoidance of allogeneic blood transfusion, and number of DVTs between two groups were not statistically significant.