彩超检测在预防人工关节置换术后下肢深静脉血栓形成的应用  

Application of color Doppler ultrasonography in preventing deep vein thrombosis after total joint arthroplasty

作　　者：何炼图[1] 汤庆[1] 温燕杭[1] 肖霭仪[1] 杨通[1] 李之琛[2] 王宗信[2] 

机构地区：[1]广州医学院第一附属医院超声科,510120 [2]广州医学院第一附属医院骨科,510120

出　　处：《中华关节外科杂志（电子版）》2011年第2期7-10,共4页Chinese Journal of Joint Surgery(Electronic Edition)

摘　　要：目的探讨彩色多普勒超声监测抗凝及早期锻炼预防人工关节置换术后下肢深静脉血栓形成(DVT)的应用价值。方法对接受人工髋、膝关节置换术患者199例予术前、术后进行双下肢深静脉彩色多普勒超声检测,为术后抗凝及早期锻炼提供依据,并对检出下肢深静脉血栓阳性患者及时进行溶栓等处理,追踪观察治疗效果。结果 149例接受全髋关节置换术(THA)患者中,检出阳性患者6例,发生率为4·03%;50例接受全膝关节置换术(TKA)患者中,检出阳性患者6例,发生率为12·0%。两者共12例,总发生率6·03%,其中近心端静脉血栓1例(8·33%),远心端静脉血栓11例(91·67%)。阳性患者经加强抗凝、溶栓后血栓完全复通者5例,血栓缩小、机化者7例。结论抗凝及早期锻炼可较好地预防人工关节置换术患者下肢DVT;彩色多普勒超声对人工关节置换术患者下肢DVT可起到早期发现、及时干预的作用。Objective To explore color Doppler ultrasonography application for surveillance of anticoagulation and prevention of deep vein thrombosis （DVT） by early exercises after total joint arthroplasty. Methods Color Doppler ultrasonography was used to detect DVT before and after operation in 199 patients who accepted total joint arthroplasty, providing the basic evidences for anticoagulation and early exercises. The DVTpositive patients received thrombolitic therapy promptly, and the effects of treatment were evaluated. Results There were six out of 149 patients after total hip arthroplasty and six out of^·50 patients after total knee arthroplasty who developed DVT. The incidence of DVT was 4. 03% in THA and 12. 0% in TKA; the total incidence of DVT was 6. 03%. The thrombus of one case was in proximal vein, and thrombi of the other 11 cases were in distal veins. The vessels of five cases restored unobstructedly, and the organization of thrombi was found in other seven cases. Conclusions Anticoagulation and early exercises are beneficial for DVT prevention after total joint arthroplasty. Color Doppler ultrasonography is possible to early discover and promptly intervene in DVT after total joint arthroplasty.

关 键 词：超声检查 多普勒 彩色 关节成形术 置换 静脉血栓形成 

分 类 号：R687.4[医药卫生—骨科学]