摘要
目的基于多普勒超声检查联合D-二聚体检测,探讨膝关节骨性关节炎患者行全膝关节置换术(TKA)后恐动症的发生率及其与下肢深静脉血栓(DVT)形成的关系。方法回顾性分析2019年1月—2020年12月于该院就诊的171例单侧原发性膝关节骨性关节炎患者的临床资料,并记录患者的临床数据。在TKA术后24 h内,使用中文版恐动症评分表(TSK)评估恐动症水平。术前及术后进行下肢彩色多普勒超声检查联合D-二聚体监测筛查DVT。比较恐动症患者与非恐动症患者术后14 d内DVT的发生率情况。使用多因素Logistic回归分析评估DVT的潜在危险因素。结果总共纳入111例患者,存在恐动症的患者35例(31.5%),无恐动症患者76例(68.5%)。恐动症组35例中有12例(34.3%)发生下肢深静脉血栓,非恐动症组76例中有13例(17.1%)发生下肢深静脉血栓,两组差异有统计学意义(P=0.044)。多因素Logistic回归分析显示,恐动症患者发生下肢深静脉血栓的风险是无恐动症患者的3.169倍(95%CI 1.189~8.445,P=0.021)。与非恐动症组相比,恐动症组术后D-二聚体平均值水平更高,但差异无统计学意义(P=0.541)。结论TKA患者术后出现恐动心理的发生率较高,且TKA术后恐动症的患者14 d内DVT发生率明显高于无恐动症患者。
Objective To investigate the incidence of kinesiophobia and its relationship with the deep vein thrombosis of lower extremity after total knee arthroplasty in patients with knee osteoarthritis based on Doppler ultrasound combined with D-dimer detection.Methods Eligible 171 cases patients with KOA who were scheduled for unilateral primary TKA in the hospital between January 2019 and December 2020 were included in this retrospective study.The demographic and clinical features were recorded.The level of kinesiophobia was evaluated using the Chinese version of the Tampa Scale or Kinesiophobia(TSK)within 24 h after the TKA surgery.Color Doppler ultrasound combined with D-dimer monitoring was performed pre-and postoperatively to screen for DVT.The incidence of DVT within postoperative 14 d was compared between patients with kinesiophobia and patients without kinesiophobia.The multiple Logistic regression analysis was also used to evaluate potential risk factors for DVT.Results A total of 111 patients were included for the final analysis,35 cases(31.5%)had kinesiophobia and 76(68.5%)had not.12 cases(34.3%)of 35 cases in the panic disorder group developed deep venous thrombosis of the lower extremities,and 13 cases(17.1%)of the 76 cases in the non-motion disorder group developed deep venous thrombosis of the lower extremities.The difference between the two groups was statistically significant(P=0.044).Logistic regression analysis showed that the risk of DVT was 3.169 fold higher in patients with than without kinesiophobia(95%CI 1.189-8.445,P=0.021).Postoperative median D-dimer values were numerically higher in the kinesiophobia group compared to non-kinesiophobia group during hospitalization after surgery,but this difference was not statistically significant(P=0.541).Conclusion The incidence of kinesiophobia in patients after TKA is high,and the incidence of DVT within 14 d after TKA was significantly higher in patients with kinesiophobia than patients without kinesiophobia.
作者
詹自玉
余博飞
ZHAN Ziyu;YU Bofei(Department of Ultrasound imaging,the First Affiliated Hospital of Fujian Medical University,Fuzhou,Fujian Province,350005 China;Department of orthopedics,Fujian Provincial Hospital,Fuzhou,Fujian Province,350001 China)
出处
《中外医疗》
2021年第26期69-72,共4页
China & Foreign Medical Treatment
关键词
彩色多普勒超声
运动障碍
恐动症
全膝关节置换术
深静脉血栓
Color Doppler ultrasound
Fear of movement
Kinesiophobia
Total knee arthroplasty
Deep vein thrombosis
