股骨颈骨折行髋关节置换术围手术期下肢深静脉血栓形成的影响因素

Influencing Factors of Lower Extremity Deep Venous Thrombosis at Perioperative Period of Hip Replacement for Femoral Neck Fracture

目的研究股骨颈骨折行髋关节置换术患者围手术期下肢深静脉血栓形成的影响因素。方法选取2019年10月-2021年10月在我院接受髋关节置换术的62例股骨颈骨折患者作为研究对象,根据是否发生下肢深静脉血栓形成分为两组,收集患者相关临床资料,进行单因素和Logistic多因素分析。结果单因素结果显示:患者年龄、体质指数、合并糖尿病、手术时间、术中出血量麻醉方式及术中使用假体类型为股骨颈骨折行髋关节置换术下肢深静脉血栓形成的影响因素。Logistic多因素分析结果显示:年龄≥40岁,合并糖尿病、全麻、双侧髋关节置换术、应用骨水泥型假体为股骨颈骨折行髋关节置换术患者下肢深静脉血栓形成的高危因素。结论影响股骨颈骨折行髋关节置换术患者下肢深静脉血栓形成的因素众多,其中年龄≥40岁、合并糖尿病、手术全麻、双侧髋关节置换术、应用骨水泥型假体是影响患者下肢深静脉血栓形成的独立性因素。术前对患者年龄,是否合并糖尿病情况进行评估;术后对患者麻醉方式、髋关节置换数量及术中应用假体类型进行评估。针对存在独立性因素的患者应给予适当治疗护理干预,预防术后下肢深静脉血栓形成。

Objective:To study the influencing factors of lower extremity deep venous thrombosis at perioperative period of hip replacement for femoral neck fracture.Methods:A total of 62 patients with femoral neck fracture who underwent hip replacement in our hospital from October 2019 to October 2021 were selected,and were divided into two groups according to whether there was lower extremity deep venous thrombosis.The relevant clinical data of the patients were collected and analyzed by single factor and logistic multiple factor analysis.Results:The univariate results showed that age,body mass index,diabetes,operation time,intraoperative bleeding,anesthesia method and the type of prosthesis used during operation were the influencing factors of lower extremity deep venous thrombosis in hip replacement for femoral neck fracture.Logistic multivariate analysis showed that the age≥40 years old,combined with diabetes,general anesthesia,bilateral hip arthroplasty,and the use of cement prosthesis were the high risk factors for lower extremity deep venous thrombosis in patients with femoral neck fracture undergoing hip replacement.Conclusion:There are many factors that affect the formation of deep venous thrombosis in patients with femoral neck fracture undergoing hip replacement.Among them,age≥60 years old,combined with diabetes,surgical general anesthesia,bilateral hip replacement,and the use of bone cement prosthesis are independent factors that affect the formation of deep venous thrombosis in patients with lower extremity.The age of patients,whether combined with diabetes or not,and the anesthesia methods,the number of hip replacement and the type of prosthesis used during the operation were evaluated.Patients with independent factors should be given appropriate treatment and nursing intervention to prevent postoperative deep venous thrombosis of lower limbs.