全髋及全膝关节置换后下肢深静脉血栓形成的季节因素

Seasonal variation in the occurrence of deep venous thrombosis after total hip and knee arthroplasty

背景:有研究确认大宗人群中下肢深静脉血栓及肺栓塞与季节有明确相关性,但没有关于全髋及全膝关节置换后下肢深静脉血栓形成的季节因素的相关研究。目的:分析全髋及全膝关节置换后患者下肢深静脉血栓发生率与季节的相关性。方法:对866例行全髋及全膝人工关节置换的1 114个关节进行回顾性分析,共506个髋关节,608个膝关节。其中,男313例420个关节,287髋、133膝;女553例694个关节,219髋、475膝。平均年龄(60.98±0.87)岁。关节置换后3,7,10 d复查彩超检测下肢和盆腔深静脉行下肢多普勒彩超检查,分析下肢下肢深静脉血栓发生率与季节的相关性。结果与结论:人工关节置换后下肢深静脉血栓发生率,夏冬季差异最明显(χ2=7.190,P=0.007),春夏(χ2=6.995,P=0.008)、秋夏季(χ2=5.663,P=0.017)比较差异有显著性意义(P<0.05);春秋、秋冬、春冬季节之间差异无显著性意义(P>0.05)。表明季节与关节置换后血栓发生率有明显的相关性,冬季发生率最高。

BACKGROUND：Deep vein thrombosis and pulmonary embolism are certainly related to seasons. OBJECTIVE：To analyze whether there is a seasonal pattern for deep venous thrombosis （DVT） after total hip and knee arthroplasty. METHODS：We retrospected 866 patients （1 114 joints） underwent total hip and knee arthroplasty. There were 506 cases of total hip arthroplasty, including 287 male cases and 219 female cases, and 608 cases of total knee arthroplasty, including 133 male cases and 475 female cases. The average age was （60.98±0.87） years. After arthroplasty, patients were given color Doppler ultrasound in the deep veins of the lower limbs and pelvis to analyze the correlation between occurrence of deep vein thrombosis and seasons. RESULTS AND CONCLUSION：There was a significant difference in the incidence of deep vein thrombosis in summer and winter （χ2=7.190, P=0.007）, in summer and spring （χ2=6.995, P=0.008）, as wel as in summer and autumn （χ2=5.663, P=0.017）. No statistical differences were tested in spring and autumn, in autumn and winter, and in spring and winter （P〉0.05）. These findings indicate that there is a seasonal variation of deep venous thrombosis after arthroplasty, and the highest incidence of deep vein thrombosis is in winter.