全流程干预对膝关节置换术患者术后下肢深静脉血栓形成风险的影响  

Impact of full process intervention on the risk of postoperative lower extremity deep vein thrombosis formation in patients undergoing knee arthroplasty

作　　者：龙飞 王丽丽[1] 张伟[1] 张磊[2] Long Fei;Wang Lili;Zhang Wei;Zhang Lei(Department of Anesthesiology,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,Xinjiang,China;Department of Vascular Thyroid Surgery,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,Xinjiang,China)

机构地区：[1]新疆医科大学第一附属医院麻醉科,新疆乌鲁木齐830000 [2]新疆医科大学第一附属医院血管甲状腺外科,新疆乌鲁木齐830000

出　　处：《血管与腔内血管外科杂志》2024年第8期930-934,共5页Journal of Vascular and Endovascular Surgery

基　　金：新疆维吾尔自治区自然科学基金资助项目(2022D01C753)。

摘　　要：目的探讨全流程干预对膝关节置换术患者术后下肢深静脉血栓(DVT)形成风险的影响。方法收集2022年6月至2023年5月于新疆医科大学第一附属医院接受膝关节置换术的168例患者的临床资料,根据是否接受了全流程干预将患者分为干预组(n=86)和对照组(n=82)。比较两组患者的手术相关指标和术后住院期间相关指标,主要观察术后住院期间下肢DVT的发生率。结果两组患者的手术疾病情况、手术时长、术中出血量比较,差异均无统计学意义(P﹥0.05);干预组患者术中低体温的发生率低于对照组患者,差异有统计学意义(P﹤0.05)。术后住院期间,干预组患者下肢DVT的发生率为2.3%(2/86),低于对照组患者的11.0%(9/82),差异有统计学意义(P=0.023)。干预组患者术后住院期间D-二聚体水平升高的比例为4.7%(4/86),低于对照组患者的15.9%(13/82),差异有统计学意义(P﹤0.05)。两组患者的术后凝血酶原时间和活化部分凝血活酶时间比较,差异均无统计学意义(P﹥0.05)。结论全流程干预可以降低膝关节置换术患者术后下肢DVT的发生率,同时不增加术后住院期间其他并发症的发生风险。Objective To investigate the impact of full process intervention on the risk of lower extremity deep vein thrombosis(DVT)formation in patients undergoing knee arthroplasty.Method The clinical data of 168 patients who underwent knee arthroplasty at the First Affiliated Hospital of Xinjiang Medical University from June 2022 to May 2023 were collected.The patients were divided into intervention group(n=86)and control group(n=82)based on whether they have received full process intervention.The surgical related indicators and postoperative hospitalization related indicators between two groups of patients were compared,and the incidence of lower extremity DVT during postoperative hospitalization was mainly observed.Result There were no statistically significant difference in the surgical disease condition,surgical duration,and intraoperative bleeding between the two groups of patients(P>0.05);the incidence of intraoperative hypothermia in the intervention group was lower than that in the control group,and the difference was statistically significant(P<0.05).During postoperative hospitalization,the incidence of lower extremity DVT in the intervention group was 2.3%(2/86),which was lower than the 11.0%(9/82)in the control group,and the difference was statistically significant(P=0.023).The proportion of patients in the intervention group with elevated D-dimer levels during postoperative hospitalization was 4.7%(4/86),which was lower than the 15.9%(13/82)of patients in the control group,and the difference was statistically significant(P<0.05).There were no statistically significant differences in postoperative prothrombin time and activated partial thromboplastin time between the two groups of patients(P>0.05).Conclusion Full process intervention can reduce the incidence of postoperative lower extremity DVT in patients undergoing knee arthroplasty,while not increasing the risk of other complications during postoperative hospitalization.

关 键 词：全流程干预 腰硬联合麻醉 膝关节置换术 深静脉血栓 

分 类 号：R543[医药卫生—心血管疾病]