单髁膝关节置换围手术期预防性抗凝的现状

Perioperative anticoagulation practices in unicompartmental knee arthroplasty

摘要:

单髁置换术和全膝置换术均已经是治疗终末期膝关节骨性关节炎的重要方式，全膝置换术后进行抗凝以预防静脉血栓栓塞导致严重临床后果已经成为临床共识。但目前，单髁置换术围术期预防性抗凝方案并没有形成指南，临床上多参照全膝置换术的抗凝方案来进行。相比于全膝置换术，单髁置换术具有自身特点，例如创伤更小、恢复更快，单纯照搬全膝置换术的围术期预防抗凝策略显然是不合时宜的。本综述梳理了单髁置换术围术期的预防性抗凝方式，总结当前围术期预防性抗凝的发展趋势，为关节外科医生制定单髁置换术患者的抗凝方案和思考预防性抗凝的未来发展方向提供参考。

Abstract:

Both unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) are essential approaches for treating endstageknee osteoarthritis. It is a now clinical consensus to administer anticoagulation in TKA to prevent thromboembolism and mitigate seri-ous clinical consequences. However, there currently is no established guideline for perioperative prophylactic anticoagulation in UKA, andclinical practices often reference those used in TKA. In comparison to TKA, UKA involves smaller trauma and faster recovery. Simply adopt-ing the anticoagulation strategy from TKA appears outdated. This review systematically examines the perioperative anticoagulation approach-es for UKA, summarizes the current trends in perioperative anticoagulation, and provides insights to guide the formulation of perioperativeanticoagulation plans for patients undergoing UKA. Additionally, it offers considerations for the future development directions of anticoagula-tion.