彩色多普勒超声早期监测人工关节术后深静脉血栓的价值

Application of color Doppler ultrasonography in detecting deep vein thrombosis after total joint arthroplasty

目的 探讨彩色多普勒超声对人工关节置换术后深静脉血栓 (DVT)早期诊断的价值。方法 应用彩色多普勒超声对 1 43例下肢人工关节置换术患者的下肢静脉进行监测。结果 发现深静脉血栓 1 2例 ,发生率约 8.4% ,所有 1 2例DVT均发生在 1周之内 ,最早在术后 2d被发现。对早期发现的血栓进行抗凝治疗可使小面积的血栓消散 ,对大面积的血栓也可起到防止播散的作用。结论 从血栓发生时间和抗凝治疗效果来看 ,彩超监测应尽早进行。彩超的主要作用有 :①发现无症状DVT ;②监测DVT的播散 ;③确定抗凝治疗效果 ;④减少抗凝剂剂量 ,预防出血倾向 ;⑤检测血栓是否牢固或机化。

Objective To discuss the early diagnosis of deep vein thrombosis (DVT) after total joint arthroplasty.Methods Color Doppler ultrasonography was used to detect DVT in 143 patients who had undergone total knee arthroplasty (TKA) or total hip arthroplasty (THA).Results DVT was found in 12 of 143 patients,the incidence was 8.4 %. All 12 cases happened during the first week after arthroplasty and the earliest case was found on the second day after arthroplasty.Anticoagulation therapy might dissolve formed small thrombus and might be beneficial to prevent dissemination of large thrombus in early time.Conclusions According to the phase DVT developed and the effect of anticoagulation therapy,color Doppler ultrasonography should be applied as early as possible,it is a useful method as following reasons:①Discovering thrombus without sympotom;②Detecting dissemination of DVT;③Evaluating effect of anticoagulation therapy;④Decreasing the dose of anticoagulant and preventing of hemorrhagic tendency;⑤Monitoring state of DVT,fixed or organized.