人工关节置换术后并发深静脉血栓形成的危险因素评估  

Risk factors for venous thromboembolism after total hip and total knee arthroplasty

作　　者：张杰[1] 陈平[1] 荣冬明 韩忠宇[1] 徐海侠[1] 雷雨田[1] 于强[1] 王崧榕 田京[1] 

机构地区：[1]南方医科大学附属珠江医院,广东广州510280

出　　处：《中国矫形外科杂志》2016年第11期1001-1005,共5页Orthopedic Journal of China

摘　　要：[目的]探讨全髋和全膝关节置换术后下肢深静脉血栓（deep venous thrombosis,DVT）形成的相关危险因素。[方法]选取2010年1月-2014年12月在本院行人工髋膝关节置换术的患者536例进行DVT的回顾性分析。选择性别、年龄、体重指数、凝血指标、吸烟史、麻醉方式、手术时长、合并慢性病史等22项与人工关节置换术后DVT形成的可能相关因素进行统计分析。[结果]216例人工膝关节置换术后发生DVT 23例,320例人工髋关节置换术患者术后发生DVT 22例,进行单因素分析表明：年龄、性别、体重指数、D-D、心肌梗死病史、深静脉血栓史是关节置换术后DVT发生的危险因素（P〈0.05）,多因素logistic回归分析表明：年龄、深静脉血栓史使术后发生DVT的风险分别增加到1.058、6.283。[结论]年龄、性别、体重指数、D-D、心肌梗死病史、深静脉血栓史等的患者发生DVT的风险较高。尤其是高龄、深静脉血栓史与术后DVT发生密切相关,需要引起临床医生的重视。[Objective] To investigate the risk factors for deep venous thrombosis after total joint arthroplasty. [Methods]Clinical data of 536 cases of total hip or knee replacement were retrospectively analyzed. The statistical indexes included sex,age,the body mass index（ BMI）, and other factors. Regression analysis was performed using Binary Logistic Regression.[Results] Of 536 cases,45 had DVT. Age,BMI,sex,D- D,myocardial infection history and deep vein thrombosis history were correlated with DVT（ P〈0. 05）. Logistic multifactor analysis indicated that age（ OR = 1. 058,P〈0. 001）,deep vein thrombosis history（ OR = 4. 238,P〈0. 001） were risk factors for DVT. [Conclusion] Older age,obesity,and myocardial infection history or deep vein thrombosis history are the independent risk factors for DVT after total joint arthroplasty. Clinical doctors should be careful for patients with older age and deep vein thrombosis history.

关 键 词：深静脉血栓 关节置换术 危险因素 

分 类 号：R687.4[医药卫生—骨科学]