下肢术后深静脉血栓形成的风险因素分析

Analyse of the risk factors of DVT after lower extremity surgery

目的:研究骨科下肢术后深静脉血栓的发生率并进行风险因素分析。方法:1999年11月至2002年5月未行预防性抗凝治疗的下肢手术患者136例,男78例,女58例;年龄16～82岁,平均49.5岁。术前行双下肢超声多普勒检查排除深静脉血栓,术后行双侧上行性静脉造影检查,并分析可能相关的风险因素。结果:关节置换术后发生深静脉血栓共24例,其中全髋置换术后10例,全膝置换术后14例。骨性关节炎、类风湿性关节炎、股骨头无菌性坏死及股骨颈骨折术后发生深静脉血栓分别为9、6、7和12例。结论:研究发现高龄、深静脉血栓既往史、合并心血管疾病、糖尿病及骨水泥、止血带的使用对深静脉血栓的形成都有较大影响。

Objectives： To investigate the morbility rate of deep venous thrombosis （DVT） after lower extremity surgery and analyze the risk factors. Methods：All 136 cases of lower extremity surgeries in the period of Nov.1999 to May. 2002 without any anti-coagulopathy agents pre-surgery were analyzed. There were 78 male and 58 female ,aged from 16 to 82 years with an average age of 49.5 years. All the cases were examined by sonography before the surgery to rule out bilateral deep venous thrombosis, and were examined bilateral lower extremities with inverse phlebography postoperation, and finally the results were used to analyze the risk factors of DVT. Results：DVT was found 24 in 51 arthroplastic patients, include 10 after THA and 14 after TKA,respectively. And the morbility rate of DVT after the surgical treatment of osteoarthritis, rheumatoid arthritis, femoral head aseptic necrosis and femoral neck fracture were 9,6,7,12, respectively. Conclusion：Patients of aged, DVT history, cardiorespiratory compromises or diabetes mellitus, and using tourniquet or bone cement during the surgery are more likely to suffer from DVT after surgery.