膝髋骨性关节炎关节置换术后下肢深静脉血栓发生的常见危险因素分析  

Analysis of common risk factors on the incidence of deep vein thrombosis after lower-extremity joint arthroplasty due to knee or hip osteoarthritis

作　　者：戴小宇[1] 姚尧[1] 徐志宏[1] 陈东阳[1] 史冬泉[1] 蒋青[1] 

机构地区：[1]南京大学医学院附属鼓楼医院关节疾病诊治中心,南京210008

出　　处：《中国矫形外科杂志》2014年第21期1939-1942,共4页Orthopedic Journal of China

基　　金：国家杰出青年科学基金(项目批准号:No.81125013)

摘　　要：[目的]分析膝、髋关节骨性关节炎（osteoarthritis,OA）人工关节置换术后下肢深静脉血栓（deep venous thrombosis,DVT）形成的常见危险因素。[方法]2010年8月~2012年2月行全膝、髋关节置换术的患者456例,所有患者均在术后3~5 d行下肢深静脉造影。根据造影结果分为DVT组（男22例,女121例;平均年龄66.97岁）和非DVT组（男68例,女245例;平均年龄65.93岁）,分析两组患者中年龄、性别、糖尿病、高血压、心血管疾病史、血栓史、恶性肿瘤史、体重指数（Body mass index,BMI）、吸烟史及手术类型与DVT发生风险的潜在相关性。[结果]OA患者中,BMI≥25 kg/m2（OR=1.716;95%CI=1.100-2.675;P=0.017）和心血管疾病史（OR=3.403;95%CI=1.129-10.260;P=0.030）能显著增加关节置换术后DVT的发生风险。[结论]高BMI和心血管疾病史是膝、髋OA患者行关节置换术后DVT发生的危险因素。[ Objective] To analyze the common risk factors of deep venous thrombosis （DVT） after joint arthroplasty due to knee or hip osteoarthritis （OA） . [ Methods] From August 2010 to February 2012, 456 patients who had undergone total knee or hip joint arthroplasty underwent venography of lower - extremity deep vein on postoperative days 3 to 5. Based on the re- sults of angiography, patients were divided into DVT group （22 males and 121 females, mean age 66. 97 years） and non - DVT group （68 males and 245 females, mean age 65.93 years） . The potential associations of DVT risk and age, gender, diabetes, hypertension, history of cardiovascular disease, VTE history, history of malignancy , body mass index （BMI） , smoking histo- ry, and types of surgery were analysed. [ Results] In OA patients, a BMI value of or more than 25 kg/m2 （OR = 1. 716; 95% CI = 1. 100 - 2. 675 ; P = 0. 017 ） and cardiovascular disease history （ OR = 3. 403 ; 95% CI = 1. 129 - 10. 260; P = O. 030） significantly increased DVT risk after joint arthroplasty. [ Conclusion] A higher BMI value and cardiovascular disease history are risk factors of DVT following joint arthroplasty in patients with knee or hip OA.

关 键 词：骨性关节炎 深静脉血栓 关节置换术 

分 类 号：R687.4[医药卫生—骨科学]