切换至 "中华医学电子期刊资源库"

中华关节外科杂志(电子版) ›› 2026, Vol. 20 ›› Issue (02) : 252 -256. doi: 10.3877/cma.j.issn.1674-134X.2026.02.016

个案报道

肩关节镜术后继发下肢静脉血栓及肺栓塞1例
李国庆1, 许超2,(), 董单1, 倪康康1, 梁博程2, 程伟翔3, 刘芬之4   
  1. 1 310053 杭州,浙江中医药大学第二临床医学院
    2 310053 杭州,浙江中医药大学附属第二医院骨伤科
    3 450046 郑州,河南中医药大学第二临床医学院
    4 471002 洛阳,河南省洛阳正骨医院(河南省骨科医院)骨关节病中心
  • 收稿日期:2025-04-24 出版日期:2026-04-01
  • 通信作者: 许超
  • 基金资助:
    浙江省中医药科技计划(2023ZL058)
  • Received:2025-04-24 Published:2026-04-01
引用本文:

李国庆, 许超, 董单, 倪康康, 梁博程, 程伟翔, 刘芬之. 肩关节镜术后继发下肢静脉血栓及肺栓塞1例[J/OL]. 中华关节外科杂志(电子版), 2026, 20(02): 252-256.

图1 患者右肩影像学提示右肩冈上肌钙化性肌腱炎。图A为右肩关节正位X线片,示冈上肌附着点处不连续的高密度钙化影;图B为右肩关节MRI的T2WI脂肪抑制图像冠状位,示冈上肌腱内低信号钙化灶,周围肌腱及滑囊可见高信号水肿影
图2 患者腹部CT影像,示中下腹巨大类椭圆形软组织密度影,大小约为15.4×13.0 cm。图A为横断位,示中下腹巨大类椭圆形软组织密度影,边界清晰;图B为冠状位,示子宫体积显著增大,密度尚均匀;图C为矢状位,示巨大子宫肌瘤占据盆腔及部分腹腔
[1]
Pitsilos C, Papadopoulos P, Givissis P, et al. Pulmonary embolism after shoulder surgery: Is it a real threat?[J/OL]. World J Methodol, 2025, 15(1): 98343. DOI: 10.5662/wjm.v15.i1.98343.
[2]
杨华湘, 谭明洁, 李扬杰, 等. 血小板自噬与血小板功能的研究进展[J]. 中华医学杂志, 2023, 103(22): 1729-1732.
[3]
中华医学会血液学分会红细胞疾病(贫血)学组. 铁缺乏症和缺铁性贫血诊治和预防的多学科专家共识(2022年版)[J]. 中华医学杂志, 2022, 102(41): 3246-3256.
[4]
Leukemia and Lymphoma Group Chinese Society of He, 中华医学会血液学分会白血病淋巴瘤学组. 原发性血小板增多症诊断与治疗中国专家共识(2016年版)[J]. 中华血液学杂志, 2016, 37(10): 833-836.
[5]
Li S, Wang L, Lu Q. Comparison of the predictive power of the 2005 and 2010 Caprini risk assessment models for deep vein thrombosis in Chinese orthopedic patients at admission: a prospective cohort study[J]. Thromb Res, 2023, 222: 1-6.
[6]
Lin H-Y, Lin C-Y, Huang Y-C, et al. Deep vein thrombosis after major orthopedic surgery in Taiwan: A prospective cross-sectional study and literature review[J]. J Formos Med Assoc, 2022, 121(8): 1541-1549.
[7]
Jamil M, Dandachli W, Noordin S, et al. Hip arthroscopy: Indications, outcomes and complications[J]. Int J Surg, 2018, 54(Pt B): 341-344.
[8]
Brand JC, Rossi MJ, Lubowitz JH. Arthroscopy annual awards: the“old normal”[J]. Arthroscopy, 2021, 37(1): 1-6.
[9]
Jameson SS, James P, Howcroft DWJ, et al. Venous thromboembolic events are rare after shoulder surgery: analysis of a national database[J]. J Shoulder Elbow Surg, 2011, 20(5): 764-770.
[10]
Triplet JJ, Schuette HB, Cheema AN, et al. Venothromboembolism following shoulder arthroscopy: a systematic review[J]. JSES Rev Rep Tech, 2022, 2(4): 464-468.
[11]
Randelli P, Castagna A, Cabitza F, et al. Infectious and thromboembolic complications of arthroscopic shoulder surgery[J]. J Shoulder Elbow Surg, 2010, 19(1): 97-101.
[12]
Lameire DL, Abdel Khalik H, Phillips M, et al. Thromboprophylaxis after knee arthroscopy does not decrease the risk of deep vein thrombosis: a network meta-analysis[J]. Knee Surg Sports Traumatol Arthrosc, 2022, 30(7): 2364-2376.
[13]
Huang HF, Tian JL, Sun L, et al. The effect of anticoagulants on venous thrombosis prevention after knee arthroscopy: a systematic review[J]. Int Orthop, 2019, 43(10): 2303-2308.
[14]
Hill JR, McKnight B, Pannell WC, et al. Risk factors for 30-day readmission following shoulder arthroscopy[J]. Arthroscopy, 2017, 33(1): 55-61.
[15]
Westermann RW, Pugely AJ, Ries Z, et al. Causes and predictors of 30-day readmission after shoulder and knee arthroscopy: an analysis of 15, 167 cases[J]. Arthroscopy, 2015, 31(6): 1035-1040.e1.
[16]
Kirschen GW, AlAshqar A, Miyashita-Ishiwata M, et al. Vascular biology of uterine fibroids: connecting fibroids and vascular disorders[J]. Reproduction, 2021, 162(2): R1-R18.
[17]
Nawawi SH, Wan Ibrahim WZ, Yahya MM, et al. Acute lower limb ischaemia secondary to aortic compression from uterine fibroid[J/OL]. BMJ Case Rep, 2023, 16(8): e253129. DOI: 10.1136/bcr-2022-253129.
[18]
Brown D, Ghalib N, Wu J, et al. Uterine fibroid-associated massive pulmonary embolism: areport of two cases[J/OL]. Cureus, 2024, 16(6): e62436. DOI: 10.7759/cureus.62436.
[19]
Lin Q, Li T, Ding S, et al. Anemia-associated platelets and plasma prothrombin time increase in patients with adenomyosis[J/OL]. J Clin Med, 2022, 11(15): 4382. DOI: 10.3390/jcm11154382.
[20]
Aleksandrovych V, Bereza T, Ulatowska-Białas M, et al. Identification of PDGFRα+cells in uterine fibroids–link between angiogenesis and uterine telocytes[J/OL]. Arch Med Sci, 2019: 110052. DOI: 10.5114/aoms.2019.86795.
[21]
Lacharite-Roberge A-S, Raza F, Bashir R, et al. Case series of seven women with uterine fibroids associated with venous thromboembolism and chronic thromboembolic disease[J/OL]. Pulm Circ, 2019, 9(1): 2045894018803873. DOI: 10.1177/2045894018803873.
[22]
Sabat D, Skelly A, Biglione A. May-thurner syndrome, a frequently overlooked cause of iliofemoral vein thrombosis[J/OL]. Cureus, 2025, 17(3): e80212. DOI: 10.7759/cureus.80212.
[23]
Hoexum F, Hoebink M, Coveliers HME, et al. Management of Paget-schroetter syndrome: a systematic review and meta-analysis[J]. Eur J Vasc Endovasc Surg, 2023, 66(6): 866-875.
[24]
Jones MR, Prabhakar A, Viswanath O, et al. Thoracic outlet syndrome: acomprehensive review of pathophysiology, diagnosis, and treatment[J]. Pain Ther, 2019, 8(1): 5-18.
[25]
Ananthan K, Onida S, Davies AH. Nutcracker syndrome: an update on current diagnostic criteria and management guidelines[J]. Eur J Vasc Endovasc Surg, 2017, 53(6): 886-894.
[26]
Campello E, Spiezia L, Adamo A, et al. Thrombophilia, risk factors and prevention[J]. Expert Rev Hematol, 2019, 12(3): 147-158.
[27]
Connors JM. Thrombophilia testing and venous thrombosis[J]. N Engl J Med, 2017, 377(12): 1177-1187.
[28]
Bongiovanni SL, Ranalletta M, Guala A, et al. Case reports: heritable thrombophilia associated with deep venous thrombosis after shoulder arthroscopy[J]. Clin Orthop Relat Res, 2009, 467(8): 2196-2199.
[29]
Chaturvedi S, McCrae KR. The antiphospholipid syndrome: still an Enigma[J]. Hematology Am Soc Hematol Educ Program, 2015, 2015: 53-60.
[30]
Tanaka TN, Bejar R. MDS overlap disorders and diagnostic boundaries[J]. Blood, 2019, 133(10): 1086-1095.
[31]
Colucci G, Tsakiris DA. Thrombophilia screening revisited: an issue of personalized medicine[J]. J Thromb Thrombolysis, 2020, 49(4): 618-629.
[32]
Murvai VR, Radu C-M, Galiș R, et al. The relationship between thrombophilia and modifications in first-trimester prenatal screening markers[J/OL]. Medicina, 2025, 61(2): 318. DOI: 10.3390/medicina61020318.
[33]
Favaloro EJ. The futility of thrombophilia testing[J]. Clin Chem Lab Med, 2014, 52(4): 499-503.
[34]
Middeldorp S, Nieuwlaat R, Baumann Kreuziger L, et al. American Society of Hematology 2023 guidelines for management of venous thromboembolism: thrombophilia testing[J]. Blood Adv, 2023, 7(22): 7101-7138.
[35]
Twine CP, Kakkos SK, Aboyans V, et al. Editor’s choice–European society for vascular surgery(ESVS)2023 clinical practice guidelines on antithrombotic therapy for vascular diseases[J]. Eur J Vasc Endovasc Surg, 2023, 65(5): 627-689.
[36]
《中国血栓性疾病防治指南》专家委员会. 中国血栓性疾病防治指南[J]. 中华医学杂志, 2018, 98(36): 2861-2888.
[37]
Middeldorp S. Inherited thrombophilia: a double-edged sword[J]. Hematology Am Soc Hematol Educ Program, 2016, 2016(1): 1-9.
[38]
Zeuzem-Lampert C, Groene P, Brummer V, et al. Cardiorespiratory effects of perioperative positioning techniques[J]. Anaesthesist, 2019, 68(12): 805-813.
[39]
Abengochea A, Morales-Roselló J, Del Río-Vellosillo M, et al. Effect of lateral tilt angle on the volume of the abdominal aorta and inferior vena Cava in pregnant and nonpregnant women determined by magnetic resonance imaging[J]. Anesthesiology, 2015, 123(3): 733-734.
[40]
Nagahiro I, Watanuki Y, Sato S, et al. Venous velocity of the right femoral vein decreases in the right lateral decubitus position compared to the supine position: a cause of postoperative pulmonary embolism?[J]. Acta Med Okayama, 2007, 61(2): 57-61.
[41]
Li X, Eichinger JK, Hartshorn T, et al. A comparison of the lateral decubitus and beach-chair positions for shoulder surgery: advantages and complications[J]. J Am Acad Orthop Surg, 2015, 23(1): 18-28.
[42]
Edgar R, Nagda S, Huffman R, et al. Pulmonary embolism after shoulder arthroscopy[J/OL]. Orthopedics, 2012, 35(11): e1673-6. DOI: 10.3928/01477447-20121023-31.
[43]
Kuremsky MA, Cain EL Jr, Fleischli JE. Thromboembolic phenomena after arthroscopic shoulder surgery[J]. Arthroscopy, 2011, 27(12): 1614-1619.
[44]
Ji L, Lyu CL, Feng M, et al. Asymptomatic pulmonary embolism after shoulder arthroscopy: case report and literature review[J]. Orthop Surg, 2021, 13(3): 1119-1125.
[45]
Wang Y, Chen X, Wu Q, et al. Prone position increases the risk of postoperative deep vein thrombosis in cervical spine surgery by limiting venous return in the lower limbs[J]. Spine, 2024, 49(16): 1154-1161.
[46]
Chikhani M, Evans DL, Blatcher AW, et al. The effect of prone positioning with surgical bolsters on liver blood flow in healthy volunteers[J]. Anaesthesia, 2016, 71(5): 550-555.
[47]
Likhvantsev VV, Landoni G, Berikashvili LB, et al. Hemodynamic impact of the trendelenburg position: asystematic review and meta-analysis[J]. J Cardiothorac Vasc Anesth, 2025, 39(1): 256-265.
[48]
Spruce L, Van Wicklin SA. Back to basics: positioning the patient[J]. AORN J, 2014, 100(3): 298-305.
[49]
Hart A, Wyles CC, Abdel MP, et al. Thirty-day major and minor complications following total hip arthroplasty-acomparison of the direct anterior, lateral, and posterior approaches[J]. J Arthroplasty, 2019, 34(11): 2681-2685.
[50]
Ko M-S, Choi C-H, Yoon H-K, et al. Risk factors of postoperative complications following total knee arthroplasty in Korea: a nationwide retrospective cohort study[J/OL]. Medicine, 2021, 100(48): e28052. DOI: 10.1097/MD.0000000000028052.
[51]
Bohl DD, Ondeck NT, Darrith B, et al. Impact of operative time on adverse events following primary total joint arthroplasty[J]. J Arthroplasty, 2018, 33(7): 2256-2262.e4.
[52]
Thery C, Antoni M, Dujeux C, et al. Increased operative time has a negative impact on clinical outcome in arthroscopic rotator cuff repair[J]. Eur J Orthop Surg Traumatol, 2023, 33(7): 2865-2871.
[53]
Agarwalla A, Gowd AK, Yao K, et al. A 15-minute incremental increase in operative duration is associated with an additional risk of complications within 30 days after arthroscopic rotator cuff repair[J/OL]. Orthop J Sports Med, 2019, 7(7): 2325967119860752. DOI: 10.1177/2325967119860752.
[54]
Boddapati V, Fu MC, Schairer WW, et al. Increased shoulder arthroscopy time is associated with overnight hospital stay and surgical site infection[J]. Arthroscopy, 2018, 34(2): 363-368.
[55]
Sager B, Ahn J, Tran J, et al. Timing and risk factors for venous thromboembolism after rotator cuff repair in the 30-day perioperative period[J]. Arthroscopy, 2019, 35(11): 3011-3018.
[56]
Kim JYS, Khavanin N, Rambachan A, et al. Surgical duration and risk of venous thromboembolism[J]. JAMA Surg, 2015, 150(2): 110-117.
[57]
Kusnezov N, Iyer A, Richardson MK, et al. Risk factors for venous thromboembolism following total knee arthroplasty: an analysis of 3, 052 pulmonary emboli[J]. J Am Acad Orthop Surg, 2025, 33(7): e380-e390.
[58]
Qiao L, Yao Y, Wu D, et al. The validation and modification of the caprini risk assessment model for evaluating venous thromboembolism after joint arthroplasty[J]. Thromb Haemost, 2024, 124(3): 223-235.
[59]
Krauss ES, Segal A, Dengler N, et al. Utilization of the caprini score for risk stratification of the arthroplasty patient in the prevention of postoperative venous thrombosis[J]. Semin Thromb Hemost, 2022, 48(4): 407-412.
[60]
Nimeri AA, Gamaleldin MM, McKenna KL, et al. Reduction of venous thromboembolism in surgical patients using a mandatory risk-scoring system: 5-year follow-up of an American college of surgeons national surgical quality improvement program[J]. Clin Appl Thromb Hemost, 2017, 23(4): 392-396.
[61]
Shiota M, Kotani Y, Umemoto M, et al. Deep-vein thrombosis is associated with large uterine fibroids[J]. Tohoku J Exp Med, 2011, 224(2): 87-89.
[62]
Platt JF, Bree RL, Davidson D. Ultrasound of the normal nongravid uterus: correlation with gross and histopathology[J]. J Clin Ultrasound, 1990, 18(1): 15-19.
[63]
Stoelinga B, Huirne J, Heymans MW, et al. The estimated volume of the fibroid uterus: a comparison of ultrasound and bimanual examination versus volume at MRI or hysterectomy[J]. Eur J Obstet Gynecol Reprod Biol, 2015, 184: 89-96.
[64]
Isono W, Wada-Hiraike O, Sugiyama R, et al. Prediction of the operative time for hysteroscopic myomectomy for leiomyomas penetrating the intramural cavity using leiomyoma weight and clinical characteristics of patients[J]. Reprod Med Biol, 2018, 17(4): 487-492.
No related articles found!
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?