髋关节置换后的深静脉血栓  

Deep vein thrombosis after hip replacement

作　　者：闫固宁[1] 何亮亮[1] 

机构地区：[1]宁夏固原市人民医院骨二科,宁夏回族自治区固原市756000

出　　处：《中国组织工程研究》2013年第4期720-727,共8页Chinese Journal of Tissue Engineering Research

摘　　要：背景:深静脉血栓是髋关节置换后常见的并发症,随着髋关节置换的广泛应用,深静脉血栓的发生率在逐渐升高。目的:研究髋关节置换后深静脉血栓形成的风险因素和发生机制以及药物治疗效果,为临床患者提供更好的防治选择。方法:对髋关节置换后的患者进行随访,统计深静脉血栓形成的发生率以及相关危险因素,用免疫生化检测的方法检测髋关节治疗前后炎性细胞因子和细胞粘附分子的表达水平,明确深静脉血栓的发生机制,并给予低分子肝素进行预防治疗,明确防治应用效果。结果与结论:高龄、女性、肥胖、双侧髋关节同时置换、治疗时采用全身麻醉、应用骨水泥型假体、长期卧床、合并各种代谢性疾病均是髋关节置换后深静脉血栓发生的危险因素,大多数文献研究显示O型血型属于保护因素。在髋关节置换后深静脉血栓形成的过程中炎性细胞因子和细胞黏附分子的表达水平提示血栓发生的风险。应用低分子肝素可以降低髋关节置换后深静脉血栓的发生率,具有良好的防治作用。BACKGROUND： Deep vein thrombosis is a common complication after hip replacement. With the extensive application of the hip replacement, the incidence of deep vein thrombosis is gradually increased.OBJECTIVE： To study the risk factors and mechanism of deep vein thrombosis after hip replacement as well as the effect of drug treatment, in order to provide better prevention and treatment options for clinical patients.METHODS： The patients with hip replacement were followed-up to analyze the incidence rate and related risk factors of deep vein thrombosis. The expressions of inflammatory cytokines and cell adhesion molecules before and after hip replacement were detected with immunohistochemical detection method to identify the mechanism of deep vein thrombosis, and give the low molecular weight heparin for prevention and treatment as well as to indentify the application effect of prevention and treatment.RESULTS AND CONSLUSION： Elderly, females, obesity, bilateral hip replacement, general anesthesia in the treatment, application of bone cement prosthesis, long-time bed rest, merged with various metabolic diseases are the risk factors of deep vein thrombosis after hip replacement. Most studies have shown that O-blood type is the protective factor. The expression levels of inflammatory cytokines and cell adhesion molecules can indicate the incidence of deep vein thrombosis after hip replacement. Low molecular weight hepadn can reduce the incidence of deep vein thrombosis after hip replacement, which has a good effect in the prevention and treatment of deep vein thrombosis.

关 键 词：骨关节植入物 骨关节植入物学术探讨 髋关节置换 深静脉血栓 体质量指数 假体类型 高血压 糖尿病 血小板 炎性细胞因子 细胞黏附分子 白细胞介素1 白细胞介素6 白细胞介素10 肿瘤坏死因子 低分子肝素 

分 类 号：R318[医药卫生—生物医学工程]