摘要
[目的]分析人工全髋关节置换术后下肢深静脉血栓形成的临床危险因素。[方法]纳入2007年2～7月48名患者51例全髋置换手术病例,术前和术后第7d进行双下肢血管彩超检查,分析15项临床因素与术后下肢深静脉血栓(DVT)的发生有无相关性。[结果]经双下肢血管彩超检查,51例手术有17例发现DVT,全部为小腿肌间静脉血栓,DVT发生率33.3%;DVT患者中无症状者占47.1%(8/17);多因素Logistic回归分析表明:年龄≥65岁,输血总量大和血清甘油三脂水平(TG)高是全髋关节置换术后DVT发生的重要危险因素,其OR(OddRatio)值分别为:116.597、1.01和37.249(P<0.05)。[结论]女性,年龄大,肥胖,血清甘油三脂和胆固醇升高,"O"型血、输血总量大,患糖尿病和高血压的患者发生DVT的风险高(relativerisk,RR>1);年龄≥65岁、输血总量大和血清甘油三脂水平高是人工全髋关节置换术后并发DVT的危险因素;术后应控制输血量,需要大量输血者采取少量多次输血;下肢肌间静脉血栓的发生应该引起临床医师和B超医师的注意。
[ Objective ] To analyze the clinical risk factors for the deep vein thrombosis （DVT） after the total hip arthoplasty （THA） . [ Methods ] Fifty - one THA in 48 patients from February 2007 to July 2007 were evaluated. Color Doppler uhrasonography was used to detect DVT of bilateral lower extremities in all patients before operatioon and at 7 days after operation. Fifteen clinical factors were examined perioperatively in order to analyze their influences on DVT formation after surgery. [ Results] Seventeen patients with DVT after operation were discovered through Color Doppler ultrasonic detection, and all of the DVT occurred at the calf intermuscular vein. The incidence of the DVT in all patients was 33.3%, and 41.7% of these DVT patients were asymptomatic. Logistic regression analysis indicated that patients older than 65 （ OR = 116. 597 ） , large volume of blood transfusion （ OR = 1.01 ） and high level of triglycerides （ OR = 37. 249） were the risk factors for the occurrence of DVT after the THA. [ Conclusion] Female, old age, obesity, increase of the level of triglycerides and cholesteral, O blood type, large volume of blood transfusion and patients with diabetes or hypertension raised possibility the occurrence of DVT. Based on this research, it concludes that patients older than 65, large volume of blood transfusion and high level of triglycerides are the risk factors for the occurrence of DVT after the THA, doctors should control the total dose of blood transfusion, to reduce the dose per time and increase the times of massive blood transfusion. Besides these, both clinicians and doctors performing Color Doppler ultrasonography should pay attention to the calf internuscular DVT.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2009年第13期965-969,共5页
Orthopedic Journal of China
关键词
髋关节置换
关节成形术
深静脉血栓
危险因素
hip joint replacement
arthroplasty
deep vein thrombosis
risk factors
