大腿切断後の短断端に生じた深部静脈血栓症による急性肺血栓塞栓症の1例

A Case of Thromboembolism and Deep Venous Thrombosis after Transfemoral Amputation with Short Stump

はじめに

　深部静脈血栓症（deep venous thrombosis：DVT）による急性肺血栓塞栓症（pulmonary thromboembolism：PTE）は術後の重大な合併症であり，リハビリテーション治療内容や予後にも大きく影響する．DVT発症予防のために早期離床，関節可動域訓練，弾性ストッキングの着用，間欠的空気圧迫法が用いられ，よりリスクの高い症例では抗凝固療法が適用される．今回大腿切断後の短断端に生じたDVTによるPTEの1例を経験したので報告する．なお，本症例報告について論文投稿することについて患者本人に十分に説明を行い，書面にて同意を得ている．

Abstract

An 82-year-old patient underwent a left transfemoral amputation due to a malignant soft tissue tumor. He developed symptoms of chest pain and hypoxia on the 32nd day after the operation. These symptoms were caused by deep venous thrombosis (DVT) of the stump and acute pulmonary thromboembolism (PTE), for which he was treated with anticoagulant therapy. Shortly after treatment he could resume a rehabilitation therapy. Patients with a lower extremity amputation have a higher risk of developing a DVT because of immobility and increased venous pooling in the residual limb. Even with a short stump as in this case, it is important to actively train the range of motion of the joint and try to prevent DVT.