复杂全髋置换术后下肢深静脉血栓的相关因素  

Factors related to deep vein thrombosis of lower limbs after complicated total hip arthroplasty

作　　者：潘品 宋凯[1] 姚尧[1] 徐志宏[1] 张晓峰 蒋青[1] PAN Pin;SONG Kai;YAO Yao;XU Zhi-hong;ZHANG Xiao-feng;JIANG Qing(Department of Sports Medicine and Adult Reconstructive Surgery,Drum Tower Hospital,School of Medicine,Nanjing University,Nanjing 210008,China;Department of Orthopedics,Second People's Hospital of Hefei City,Hefei 230011,China)

机构地区：[1]南京大学医学院附属鼓楼医院运动医学与成人重建外科,江苏南京210008 [2]合肥市第二人民医院骨科,安徽合肥230000

出　　处：《中国矫形外科杂志》2021年第14期1249-1253,共5页Orthopedic Journal of China

基　　金：国家自然科学基金项目(编号:81702151;81871832);江苏省自然科学基金项目(编号:BK20170121)。

摘　　要：[目的]研究复杂初次全髋关节置换术(total hip arthroplasty, THA)后发生下肢深静脉血栓(deep vein thrombosis,DVT)的概率及危险因素。[方法]回顾2017年5月—2018年12月本科收治的197例行复杂初次髋关节置换术患者的临床资料,手术前后均行下肢深静脉血管超声检查以明确有无DVT形成,采用单因素及多因素逻辑回归分析DVT发生的相关因素。[结果] 197例患者中,12例术后证实发生DVT,且均为肌间DVT,发生率为6.10%。单项因素比较表明:DVT组年龄显著大于非DVT组(P<0.05),DVT组术前D-二聚体水平明显高于非DVT组(P<0.05), DVT组右侧比率显著高于非DVT组(P<0.05),DVT组H-胆固醇显著高于非DVT组(P<0.05)。多因素逻辑回归表明:术前D-二聚体(OR=1.863,95%CI 1.106-3.140,P=0.021)是DVT的危险因素,而左侧手术(OR=0.074,95%CI 0.008-0.647,P=0.021)是DVT的保护因素。[结论]复杂初次髋关节置换术后DVT发生率为6.10%,均位于肌间静脉,较高的术前D-二聚体及右侧手术是复杂全髋置换术后DVT发生的危险因素。[Objective] To explore the incidence and risk factors of deep vein thrombosis(DVT) in lower limbs after complicated primary total hip arthroplasty(THA). [Methods] A retrospective study was done on 197 patients who underwent primary THA for complicated hip disorders in our department from May 2017 to December 2018. Deep venous ultrasound examinations of the lower limbs were performed before and after the operation to determine whether DVT was formed. The univariate comparison and multivariate logistic regression were conducted to search the factors related to DVT. [Results] Among 197 patients, 12 patients were diagnosed of DVT definitively after operation, which all were intermuscular DVT, accounted for 6.10%. In term of univariate comparison, the DVT group was significantly older(P<0.05), had significantly higher the preoperative D-dimer level(P<0.05), and significantly higher ratio of THA on the right side(P<0.05)than the non-DVT group. In addition, the DVT group had significantly higher H-cholesterol than the non-DVT group(P<0.05). As results of multivariate logistic regression, preoperative D-dimer(OR=1.863, 95%CI 1.106-3.140, P=0.021) was a risk factor for DVT, whereas THA on the left side was a protective factor for DVT(OR=0.074, 95%CI 0.008-0.647, P=0.021). [Conclusion] The incidence of DVT after primary complicated total hip arthroplasty was 6.10% in this study, and all DVT located in the intermuscular vein. The higher preoperative D-dimer and THA on the right side are risk factors for DVT.

关 键 词：复杂全髋关节置换术 深静脉血栓 发生率 危险因素 

分 类 号：R687.4[医药卫生—骨科学]