髋关节置换术患者术后发生静脉血栓栓塞症的危险因素分析  

Analysis of risk factors for patients with venous thromboembolism after Hip Arthroplasty

作　　者：麦海妙 郑佐勇[1] 杨康胜[1] MAI Haimiao;ZHENG Zuoyong;YANG Kangsheng(The Second Department of Surgery,People’s Hospital of Gaoming District,Foshan City,Foshan,Guangdong 528500,China)

机构地区：[1]佛山市高明区人民医院外二科,广东佛山528500

出　　处：《医药前沿》2022年第17期9-11,共3页Journal of Frontiers of Medicine

基　　金：佛山市科技计划攻关项目(佛科〔2018〕206号)。

摘　　要：目的:分析髋关节置换术后发生静脉血栓栓塞症(VTE)的危险因素,探索预防VTE发生的有效方案。方法:以我院2016年2月—2019年4月收治的153例髋关节置换患者,根据患者术后2周内是否发生VTE分为VTE组和非VTE组,分析患者术后VTE发生率及相关危险因素,并分析引起VTE的独立危险因素。结果:153例髋关节置换患者,术后2周有52例患者发生下肢VTE,占33.99%。其中,深静脉血栓43例,占28.10%,肺静脉血栓9例,占5.88%。VTE组男性百分比、年龄、体质量指数(BMI)、吸烟史百分比、糖尿病患者百分比、高血压患者百分比、冠心病患者百分比与非VTE组相比,差异无统计学意义(P>0.05);VTE组全身麻醉患者百分比、手术时间、术前D-二聚体(DD)、术后48 h DD均明显高于非VTE组,差异有统计学意义(P<0.05)。以单因素分析有统计学差异的项目为自变量,以髋关节置换后患者是否发生VTE为因变量,进行多因素Logistic回归分析显示,全身麻醉患者比例、手术时间长是髋关节置换患者发生VTE的独立危险因素。结论:全身麻醉、手术时间长是髋关节置换术后VTE发生的独立危险因素。Objective To analyze the risk factors of venous thromboembolism(VTE)after hip arthroplasty,and to explore the effective plan to prevent the occurrence of VTE.Methods A total of 153 hip replacement patients admitted to our hospital from February 2016 to April 2019 were selected as the research objects.According to whether the patients had VTE within 2 weeks after the operation,they were divided into the VTE group and the non-VTE group.The postoperative VTE of the patients was analyzed.The incidence and related risk factors were analyzed,and the independent risk factors for VTE were analyzed.Results Among 153 hip replacement patients,52 patients had lower extremity VTE at 2 weeks after operation,accounting for 33.99%,including 43 cases of deep vein thrombosis,accounting for 28.10%,and 9 cases of pulmonary vein thrombosis,accounting for 5.88%.Compared with the non-VTE group,there were no significant differences in the percentage of males,age,body mass index(BMI),smoking history,diabetes,hypertension and coronary heart disease between the VTE group and the non-VTE group(P>0.05).The percentage of patients with general anesthesia,operation time,preoperative D-dimer(DD),and 48 h postoperative DD in the VTE group were significantly higher than those in the non-VTE group,and the differences were statistically significant(P<0.05).Taking the items with statistical differences in univariate analysis as variables,and taking the occurrence of VTE in patients after hip replacement as the dependent variable,multivariate Logistic regression analysis showed that The proportion of patients with general anesthesia,operation time,and DD at 48 hours after surgery were independent risk factors for VTE in hip replacement patients.Conclusion General anesthesia and long operation time after hip arthroplasty are independent risk factors for VTE after hip arthroplasty.

关 键 词：髋关节置换术 静脉血栓栓塞症 危险因素 

分 类 号：R543.6[医药卫生—心血管疾病]