摘要
目的探讨髋关节置换(HR)术后静脉血栓栓塞症(VTE)发生的影响因素。方法检索中国知识基础设施工程、中国生物医学文献数据库、万方数据库、维普数据库、PubMed、Web of Science、Embase、The Cochrane Library中有关HR术后VTE影响因素的研究,检索时限均从建库至2020年3月29日。由2名研究员分别独立按照标准完成文献筛选、资料提取及文献质量评价后采用Revman 5.3软件进行Meta分析,以评价HR术后VTE发生的危险因素和保护因素。结果高龄(OR=2.39, 95%CI:[1.76, 3.26])、女性(OR=3.97, 95%CI:[2.65, 5.97])、肥胖(OR=4.45, 95%CI:[2.59,7.66])、血脂异常(OR=3.73, 95%CI:[2.48, 5.63])、心脑血管疾病(OR=3.89, 95%CI:[1.98, 7.68])、高血压(OR=2.43,95%CI:[1.56, 3.80])、糖尿病(OR=2.60, 95%CI:[2.04, 3.31])、全麻(OR=9.37, 95%CI:[6.11, 14.37])、假体类型为骨水泥(OR=5.05, 95%CI:[3.20, 7.98])、术中或术后输血(OR=2.38, 95%CI:[1.06, 5.31])、手术时间长(OR=2.56, 95%CI:[1.31, 5.03])、D-二聚体升高(OR=3.81, 95%CI:[3.03, 4.79])是HR术后VTE发生的危险因素,O型血(OR=0.48, 95%CI:[0.33, 0.71])、使用抗凝药(OR=0.37, 95%CI:[0.31, 0.43])、术后功能锻炼(OR=0.45, 95%CI:[0.29, 0.68])为HR术后VTE发生的保护因素。结论通过Meta分析可获知HR术后VTE的影响因素,为医护人员提供参考,有助于临床决策的形成,从而降低患者术后VTE的发生率。
Objective To investigate the influence factors of venous thromboembolism after hip replacement.Methods Studies on influencing factors of venous thromboembolism after hip replacement were searched in Chinese National Knowledge Infrastructure, China Biology Medicine Disc, Wanfang datebase, VIP datebase,PubMed, Web of Science, Embase and The Cochrane Library from the establishment of the databases to March 29, 2020. Two researchers independently completed literature screening, data extraction and literature quality evaluation according to the standards respectively, and a Meta-analysis was performed using Revman5.3 software to evaluate the risk factors and protective factors of venous thromboembolism after hip replacement. Results Old age(OR=2.39, 95% CI: [1.76, 3.26]), female(OR=3.97, 95% CI: [2.65, 5.97]), obesity(OR=4.45, 95% CI: [2.59, 7.66]), dyslipidemia(OR=3.73, 95% CI: [2.48, 5.63]), disease of heart head bloodvessel(OR=3.89, 95% CI: [1.98, 7.68]), hypertension(OR=2.43, 95% CI: [1.56,3.80]), diabetes(OR=2.60,95% CI: [2.04, 3.31]), general anesthesia(OR=9.37, 95% CI: [6.11, 14.37]), bone cement(OR=5.05, 95% CI:[3.20, 7.98]), intraoperative or postoperative blood transfusion(OR=2.38, 95% CI: [1.06, 5.31]), long operative time(OR=2.56, 95% CI: [1.31, 5.03]), elevated D-dimer(OR=3.81, 95% CI: [3.03, 4.79]) were risk factors for venous thromboembolism after hip replacement. O blood(OR=0.48, 95% CI: [0.33, 0.71]), anticoagulants(OR=0.37, 95% CI: [0.31, 0.43]), and postoperative functional exercise(OR=0.45, 95% CI: [0.29,0.68]) were protective factors for venous thromboembolism after hip replacement. Conclusion Through the Meta-analysis, the factors affecting venous thromboembolism after hip replacement can be learned, which can provide reference for medical staff and help form clinical decisions, so as to reduce the incidence of postoperative venous thromboembolism in patients.
作者
苟玲
张亚斌
南锐伶
陈海霞
豆欣蔓
Gou Ling;Zhang Ya-bing;Nan Rui-ling;Chen Hai-xia;Dou Xin-man(School of Nursing,Lanzhou University,Lanzhou 730000,China;Department of Nursing,The Second Hospital of Lanzhou University,Lanzhou 730030,China)
出处
《兰州大学学报（医学版）》
2021年第6期89-95,共7页
Journal of Lanzhou University（Medical Sciences）
基金
2018年陇原青年创新创业人才(团队)项目(2018-7)。
