摘要
目的：分析全髋关节置换术后下肢深静脉血栓形成的影响因素，为围术期预防提供指导。方法收集行全髋关节置换手术患者52例，全部患者术后行彩超检查下肢静脉血栓情况，统计术后下肢深静脉血栓发生率，并从患者性别、年龄、血脂、D-二聚体、合并症及手术指标等方面分析下肢深静脉血栓形成的危险因素。结果52例患者中，术后发生下肢深静脉血栓16例（30．8％）；单因素分析显示年龄≥65岁、超重或肥胖（BMI≥25 kg／m2）、高甘油三酯（TG≥1．7 mmol／L）、高 D-二聚体水平（≥500μg／L）、合并糖尿病或高血压、大量输血的患者术后深静脉血栓发生率较高（P ＜0．05）；进一步行多因素回归分析显示年龄≥65岁、超重或肥胖、高甘油三酯、高 D-二聚体、糖尿病、大量输血是下肢深静脉血栓的独立危险因素（OR ＝15．693、1．278、9．832、3．053、1．855、1．014，均 P ＜0．05）。结论全髋关节置换术患者术前应进行静脉血栓风险评估，年龄≥65岁、超重或肥胖、高甘油三酯、高 D-二聚体水平、糖尿病、大量输血患者术后发生下肢深静脉血栓的风险较高，应重点加强围术期监测，规范应用低分子肝素、下肢静脉泵等，术后早期行下肢康复锻炼，尽量减少深静脉血栓的发生。
Objective To analyze the influence factors of lower extremities deep venous thrombosis after hip replacement,and provide guidance for perioperative prevention.Methods 52 cases of patients underwent total hip replacement were selected,who were given color doppler ultrasound examination for lower limb venous thrombosis after hip replacement.And analyzed risk factors of lower extremity deep vein thrombosis from patient＇s gender,age,blood lipid,D -dimer,complications and surgical index.Results During the 52 cases,16 cases were found with postopera-tive lower limb deep vein thrombosis （30.8%）;Single factor analysis showed that patients with age ≥65 years,over-weight or obese （BMI≥25kg/m2 ）,high triglycerides （TG ≥ 1.7mmol/L）and high D -dimer level （≥500μg/L）, diabetes or high blood pressure,large blood transfusion combined with a greater incidence of postoperative deep vein thrombosis （P 〈0.05）.Further multiple factors regression analysis showed that age ≥65 years,overweight or obesity, high triglycerides,high D -dimer,diabetes,large blood transfusions were independent risk factors of lower extremity deep vein thrombosis （OR =15.693,1.278,9.832,3.053,1.855,1.014,all P 〈0.05）.Conclusion Patients with total hip replacement should be given preoperative vein thrombosis risk assessment,patients with age ≥65,overweight or obese,high triglycerides,D -dimer level,diabetes,large number of blood transfusions have higher risk of deep vein thrombosis,we should focus on perioperative monitoring,application of low molecular heparin,lower limb vein pump, etc.early postoperative lower limb rehabilitation exercise,to reduce the occurrence of deep vein thrombosis.
出处
《中国基层医药》
CAS
2015年第13期1959-1963,共5页
Chinese Journal of Primary Medicine and Pharmacy
关键词
关节置换术
髋
下肢深静脉血栓
因素分析
统计学
Arthroplasty,hip
Lower extremity deep vein thrombosis
Factor analysis,statistics
