应用抗栓药后髋关节置换术后早期下肢深静脉血栓形成的临床观察  

Clinical observation of early deep venous thrombosis in lower extremities after hip arthroplasty with prophylactic antithrombotic agents

作　　者：吴石奇[1] 方冠毅[1] 陈锋[1] 熊宇 WU Shiqi;FANG Guanyi;CHEN Feng(Nanxishan Hospital of Guangxi Zhuang Autonomous Region,Guilin 541002,China)

机构地区：[1]广西壮族自治区南溪山医院

出　　处：《华夏医学》2019年第1期10-14,共5页Acta Medicinae Sinica

基　　金：广西壮族自治区卫生和计划生育委员会科研资助项目(Z2016268)

摘　　要：目的:观察应用抗栓药后髋关节置换术后并发下肢深静脉血栓患者的血液改变情况,为早期预测和干预提供参考。方法:将我院收治的100例髋关节置换患者,常规应用抗栓药,分别于置换后1,4,7 d检测患者的血液学指标改变情况。术后5~7 d行双下肢深静脉彩色多普勒超声检查,其中置换后并发下肢深静脉血栓者18例(DVT组),未并发下肢深静脉血栓者82例(非DVT组)。结果:(下肢深静脉血栓组置换后4,7 d D-二聚体、纤维蛋白原水平显著高于非下肢深静脉血栓组P<0.05),说明在应用抗栓药的情况下,D-二聚体、纤维蛋白原水平的增高与置换后发生下肢深静脉血栓呈正相关关系。结论:D-二聚体、纤维蛋白原的检测在抗栓处理后的髋关节置换术后DVT的早期预防及治疗上具有临床应用价值。Objective: To observe the changes of blood in patients with deep venous thrombosis(DVT)in lower extremity of after hip arthroplasty with antithrombotic drugs, so as to provide reference for early prediction and intervention of DVT. Methods: 100 patients with hip arthroplasty were treated with antithrombotic drugs. The changes of hematological parameters were detected at 1, 4, and 7 days after hip arthroplasty. Deep venous thrombosis was found by color by Doppler ultrasonography in 18 patients(DVT group)and 82 patients(non-DVT group)5 to 7 days after operation. Results: The levels of D-dimer and fibrinogen were significantly higher in deep vein thrombosis group than those in non-deep vein thrombosis group on the 4 th and 7 th day after replacement(P<0.05), indicating that the increased levels of D-dimer and fibrinogen were positively correlated with the occurrence of deep vein thrombosis after replacement. Conclusion: The detection of D-dimer and fibrinogen has clinical value in the early prevention and treatment of DVT after hip arthroplasty after antithrombotic treatment.

关 键 词：髋关节置换术 下肢深静脉血栓形成 D-二聚体 纤维蛋白原 

分 类 号：R687.3[医药卫生—骨科学]