人工全髖關(guān)節(jié)置換術(shù)后下肢深靜脈血栓形成的危險(xiǎn)因素分析

《人工全髖關(guān)節(jié)置換術(shù)后下肢深靜脈血栓形成的危險(xiǎn)因素分析》由會(huì)員上傳分享，免費(fèi)在線閱讀，更多相關(guān)內(nèi)容在學(xué)術(shù)論文-天天文庫。

1、人工全髖關(guān)節(jié)置換術(shù)后下肢深靜脈血栓形成的危險(xiǎn)因素分析作者：馬俊，沈彬　楊靜，周宗科，康鵬德，裴福興【摘要】[目的]分析人工全髖關(guān)節(jié)置換術(shù)后下肢深靜脈血栓形成的臨床危險(xiǎn)因素。[方法]納入2007年2～7月48名患者51例全髖置換手術(shù)病例，術(shù)前和術(shù)后第7d進(jìn)行雙下肢血管彩超檢查，分析15項(xiàng)臨床因素與術(shù)后下肢深靜脈血栓(DVT)的發(fā)生有無相關(guān)性。[結(jié)果]經(jīng)雙下肢血管彩超檢查，51例手術(shù)有17例發(fā)現(xiàn)DVT，全部為小腿肌間靜脈血栓，DVT發(fā)生率33.3%;DVT患者中無癥狀者占47.1%(8/17);多因素Logistic回歸分析表明：年齡≥65歲，輸血總量大和血清甘油三脂水平(TG

2、)高是全髖關(guān)節(jié)置換術(shù)后DVT發(fā)生的重要危險(xiǎn)因素，其OR(OddRatio)值分別為：116.597、1.01和37.249(P<0.05)。[結(jié)論]女性，年齡大，肥胖，血清甘油三脂和膽固醇升高，“O”型血、輸血總量大，患糖尿病和高血壓的患者發(fā)生DVT的風(fēng)險(xiǎn)高(relativerisk，RR>1);年齡≥65歲、輸血總量大和血清甘油三脂水平高是人工全髖關(guān)節(jié)置換術(shù)后并發(fā)DVT的危險(xiǎn)因素;術(shù)后應(yīng)控制輸血量，需要大量輸血者采取少量多次輸血;下肢肌間靜脈血栓的發(fā)生應(yīng)該引起臨床醫(yī)師和B超醫(yī)師的注意?！娟P(guān)鍵詞】髖關(guān)節(jié)置換;關(guān)節(jié)成形術(shù);深靜脈血栓;危險(xiǎn)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,