糖尿病增加全膝关节置换术后下肢深静脉血栓的风险（英文）被引量：2

Diabetes mellitus increases incidence of deep vein thrombosis after total knee arthroplasty

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摘要目的观察糖尿病是否会增加人工全膝关节置换（TKA）术后患者下肢深静脉血栓（DVT）的发生率.方法实验纳入2011年6月至2013年2月间,在本组行TKA手术的患者.根据患者是否合并有糖尿病,将其分别纳入糖尿病组与非糖尿病组.在术后第3、14天,通过彩色多普勒超声检查,诊断患者是否发生下肢DVT.比较两组间下肢DVT的发生率是否有差异,并通过逻辑回归分析糖尿病与下肢DVT的关系.结果共358例患者被纳入实验.术后14 d内,糖尿病组有52例患者发生下肢DVT,非糖尿病组有146例患者发生了下肢DVT（P〈0.05）.糖尿病组有16例患者的血栓发生在手术对侧的肢体,非糖尿病组有50例（P〉0.05）.通过Logistic回归分析,糖尿病患者术后发生下肢DVT的风险是非糖尿病患者的2.71倍 [95%CI（1.183-6.212）,P〉0.05].两组间年龄、性别、高血压患病率、BMI、手术时间、术中出血量、止血带使用时间均无统计学差异.结论虽然目前仍然存在争议,但在本实验中,糖尿病患者TKA术后下肢DVT的发生率高于非糖尿病患者. Objective To explore whether the diabetes mellitus increases the incidence of DVT in the patients undergoing the total knee arthroplasty. Methods The patients undergoing total knee arthroplasty in our hospital between June 2011 and February 2013, were included in the study. The patients were divided into diabetic group and non-diabetic group. The incidence of DVT within 14 days after the operation was compared between the diabetic patients and the non-diabetic patients; the relationship between diabetes mellitus and DVT was analysed. Results 358 patients were enrolled in this study. There were 52 patients with DVT in the diabetes group and 146 patients with DVT in the non- diabetes group within 14 days after operation （P 〈0. 05）. 16 patients in diabetic group and 50 patients in the non-diabetic group had DVT of the contralateral leg. There was no significant difference between the two groups（P 〉 0. 05）. The risk of DVT in patients with diabetes mellitus was 2. 71 times higher than the patients without diabetes mellitus according to the logistic regression modeling, （95% CI 1. 183-6. 212, P 〈 0. 05）. There were no significant difference in age, gender, hypertension, BMI, the duration of surgery, intra-operative blood loss, or the duration of tourniquet between the two groups. Conclusion Although it＇s still a controversial topic, the patients with diabetes may have higher incidence of DVT after total knee arthroplasty in our study.

作者王诗军张树栋孔刚马卫华赵中原赵宇驰

机构地区烟台市烟台山医院骨关节科

出处《中华关节外科杂志（电子版）》 CAS 2013年第6期19-24,共6页 Chinese Journal of Joint Surgery(Electronic Edition)

关键词糖尿病关节成形术置换膝静脉血栓形成 Diabetes mellitus Arthroplasty, replacement, knee Venous thrombosis

分类号 R587.1 [医药卫生—内分泌] R687.4 [医药卫生—骨科学]

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