类风湿关节炎膝关节置换后深静脉血栓发生情况及溶栓效果研究Δ  

Incidence of deep vein thrombosis and effect of thrombolysis after total knee arthroplasty in rheumatoid arthritis

作　　者：庞勇[1] 徐志宏[1] 史冬泉[1] 陈东阳[1] 蒋青[1] 

机构地区：[1]南京大学医学院附属鼓楼医院骨科,南京市210008

出　　处：《中国矫形外科杂志》2012年第13期1165-1167,共3页Orthopedic Journal of China

基　　金：国家自然科学基金面上项目资助(项目批准号:30973046)

摘　　要：[目的]探讨类风湿关节炎患者行全膝关节置换术后深静脉血栓的发病率及溶栓效果研究。[方法]2009年2月～2011年5月手术治疗类风湿关节炎24例,其中男性4例,女性20例;年龄29～74岁,平均58.2岁。双膝关节置换术6例(分两次手术),6例行左膝关节置换术,12例行右膝关节置换术。全膝关节置换术后行下肢深静脉造影诊断是否有深静脉血栓形成,术后深静脉血栓形成患者使用系统性溶栓治疗。[结果]深静脉造影术后,类风湿关节炎行全膝置换术后深静脉发生率为26.7%;系统性溶栓后,临床有效率为100%。分别在术后3、6个月随访两次。[结论]类风湿关节炎行全膝关节置换术后深静脉血栓发生率不低,值得在今后的临床工作中注意;下肢深静脉造影是关节置换术后诊断深静脉血栓形成的必要手段。[ Objective] To investigate the deep vein thrombosis rate and the thrombo｜ysis results after total knee replacement in rheumatoid arthritis patients. [ Methods] From February 2009 to May 2011, 24 rheumatoid arthritis patients were enrolled. There were 4 males and 20 females with a mean age of 58.2 years （range 29 to 74 years） . Six patients underwent bilateral total knee arthroplasty, 6 patients underwent left total knee arthroplasty, 12 patients underwent right total knee arthroplasty. After operation, all patients were carried out the contrast venography to diagnosis of deep vein thrombosis. The patients with deep vein thrombosis were received systemic thrombolytic therapy, [ Results] After contrast venography, the incidence of deep vein thrombosis in rheumatoid arthritis patients after arthroplasty was 26. 7%. The clinical effective rate was 100% after systemic thrombolytic therapy. The follow - up of 3 and 6 months respectively showed post thrombotic syndrome and recurrent thrombosis. [ Conclusion] The incidence of deep vein thrombosis in rheumatoid arthritis patients after arthroplasty are not low, it＇ s worthy of drawing attention. Contrast venography is recommended as a valuable method to diagnoze deep vein thrombosis after arthroplasty.

关 键 词：类风湿关节炎 全关节置换 深静脉血栓 下肢深静脉造影 

分 类 号：R593.22[医药卫生—内科学] R687.4[医药卫生—临床医学]