人工关节置换术后并发深静脉血栓的危险因素评估

Assessment of Risk Factors for Deep Venous Thrombosis after Total Joint Arthroplasty

目的探讨影响人工关节置换术后下肢深静脉血栓(deep venous thrombosis,DVT)形成的相关危险因素。方法回顾性分析187例人工髋、膝关节置换术的病例。选择性别、年龄、体重指数、合并症及凝血指标5项与人工关节置换术后DVT形成进行相关统计分析,行二分类Logistic回归分析筛查危险因素。结果 187例患者术后发生DVT 16例。年龄、体重指数、伴高血压或冠心病、凝血5项与DVT有相关性(P<0.05)。高纤维蛋白原(fibrinogen,Fbg)血症、肥胖、伴高血压或冠心病是DVT形成的相关危险因素,风险分别为24.318、2.108、4.431及5.506。结论高Fbg血症、肥胖、伴高血压或冠心病是人工关节置换术后并发DVT的独立危险因素,术前监测血浆Fbg水平对早期预测人工关节置换术后并发DVT具有重要意义。

To explore the risk factors for deep venous thrombosis after total joint arthroplasty. Methods A total of 187 cases of total hip or knee replacement operation were analyzed retrospectively. The statistical indexes included sex,age, the body mass in- dex（BMI） , other system disease and coagulable function tests. Regression analysis was performed using Binary Logistic Regression. Results Of 187 cases, 16 had DVT. Age, BMI, with hypertension or coronary heart disease and coagulable function tests were correlated with DVT（ P 〈 0.05 ）. High levels of fibrinogen, obesity, with hypertension or coronary heart disease were the risk factors for DVT following to- tal joint replacement. Conclusion High levels of fibrinogen, obesity, with hypertension or coronary heart disease are independent risk factors for DVT after total joint arthroplasty. Determination of plasma fibrinogen before surgery is very useful for predicting occurence of deep venous thrombosis after total joint arthroplasty.