初始全髋关节置换术静脉血栓栓塞症预防的临床研究

Clinical effects on venous thromboembolism prevention in primaryClinical primary total hip replacementtotal replacement

目的目的:评价全髋关节置换术后按照2009年版《中国骨科大手术静脉血栓栓塞症预防指南》(简称《指南》)进行静脉血栓栓塞症预防的临床效果。方法方法:回顾性分析近3年广州医科大学第一附属医院、开平市中心医院和顺德市桂洲医院共914例初始非骨水泥固定型全髋关节置换术病例,按《指南》进行预防病例为预防组(631例),未按《指南》预防病例纳入对照组(283例),观察两组血栓栓塞症预防结果、出血事件和早期并发症。结果结果:预防组的深静脉血栓栓塞症(DVT)、近端DVT、肺栓塞的发生率均显著低于对照组(6.49%vs 26.85%,5.86%vs24.02%,0.47%vs 2.82%,P<0.01)。预防组和对照组的大出血发生率分别为0.63%和2.82%(P<0.01);早期局部并发症为1.42%和3.88%(P<0.05);早期全身并发症为3.16%和7.77%(P<0.01)。结论结论:初始全髋关节置换术后按《指南》进行静脉血栓栓塞症预防,安全有效。

Objective:To investigate the clinical effects on the prevention of venous thromboembolism (DVT) in total hip arthroplasty (THA), which is based on"Chinese orthopedic major surgery venous thromboembolism prevention guidelines"(Guidelines, published in 2009). <br> Methods:Retrospective analysis was carried out in 914 patients of cementless THA in Guangdong Kaiping Central Hospi-tal, Guizhou Hospital of Shunde City and our hospital in the past three years. The patients were divided into two groups, the 631 cases in prevention group were treated with the Guidelines and 283 cases of control group did not receive any treat-ment. Occurrence of DVT, bleeding and early complications were observed. <br> Results:In the prevention group , the incidences of DVT, proximate DVT and pulmonary embolism were 6.49%, 5.86%, and 0.47%; while in the control group, the incidences of DVT, proximate DVT and pulmonary embolism were 26.85%, 24.02%, and 2.82%The two groups had statistically significant dofferemce(P<0.01). In the prevention group and control group, the hemorrhage incidence was 0.63%and 2.82%respectively, and there was statistical significance (P<0.05). The in-cidence of early systematic complications was 3.16%in prevention group and 7.77%in control group, which was also sig-nificantly different (P<0.01). <br> Conclusion:The Guidelines is safe and effective for venous thromboembolis prevention after THA.