人工全髋关节置换术后下肢深静脉血栓形成的危险因素分析

《人工全髋关节置换术后下肢深静脉血栓形成的危险因素分析》由会员上传分享，免费在线阅读，更多相关内容在学术论文-天天文库。

1、人工全髋关节置换术后下肢深静脉血栓形成的危险因素分析作者：马俊，沈彬　杨静，周宗科，康鹏德，裴福兴【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

2、)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。【关键词】髋关节置换;关节成形术;深静脉血栓;危险因素15Riskfacto

3、rsfordeepveinthrombosisaftertotalhiparthroplasty∥MAJun,SHENBin,YANGJing,etal.DepartmentofOrthopaedics,WestChinaHospitalofSichuanUniversity,Chengdu610041,China　　Abstract:[Objective]Toanalyzetheclinicalriskfactorsforthedeepveinthrombosis(DVT)afterthetotalhiparthoplasty(THA).[Methods]Fifty-on

4、eTHAin48patientsfromFebruary2007toJuly2007wereevaluated.ColorDopplerultrasonographywasusedtodetectDVTofbilaterallowerextremitiesinallpatientsbeforeoperatioonandat7daysafteroperation.FifteenclinicalfactorswereexaminedperioperativelyinordertoanalyzetheirinfluencesonDVTformationaftersurgery.[

5、Results]SeventeenpatientswithDVTafteroperationwerediscoveredthroughColorDopplerultrasonicdetection,andalloftheDVToccurredatthecalfintermuscularvein.TheincidenceoftheDVTinallpatientswas33.3%,and41.7%oftheseDVTpatientswereasymptomatic.Logisticregressionanalysisindicatedthatpatientsolderthan6

6、5(OR=116.597),largevolumeofbloodtransfusion(OR=1.01)andhighleveloftriglycerides(OR=37.249)weretheriskfactorsfortheoccurrenceofDVTaftertheTHA.[Conclusion]Female,oldage,15obesity,increaseoftheleveloftriglyceridesandcholesteral,Obloodtype,largevolumeofbloodtransfusionandpatientswithdiabetesor

7、hypertensionraisedpossibilitytheoccurrenceofDVT.Basedonthisresearch,itconcludesthatpatientsolderthan65,largevolumeofbloodtransfusionandhighleveloftriglyceridesaretheriskfactorsfortheoccurrenceofDVTaftertheTHA,doctorsshouldcontrolthetotaldoseofbloodtransfusion,