综合方法预防人工髋关节置换术后深静脉血栓形成的疗效

Clinical analysis of the prevention of deep venous thrombosis with diverse comprehensive methods after artificial hip replacements

目的探讨人工髋关节置换术后深静脉血栓形成(Deep venous thrombosis,DVT)的预防方法及效果。方法将我院2010年2月至2013年8月105例人工髋关节置换患者分为三组,每组35例,术后分别采用机械性预防、药物预防、机械和药物相结合的综合方法预防术后下肢深静脉血栓形成,检测三组患者术前、术后不同时间点的血清D-二聚体浓度,并进行分析比较,同时通过彩超检测下肢深静脉发生情况。结果组间比较,三组患者术后3 d、7 d、14 d血清D-二聚体浓度平均值数据从高到低依次为机械组、药物组、综合组;三组术后患者DVT总发生率分别为31.4%、20.0%、8.7%,差异有统计学意义(P<0.05)。结论对于人工髋关节置换术后下肢深静脉血栓形成的预防,采取机械和药物相结合的综合预防方法比采用单一机械预防或药物预防方法效果更为显著。

Objective To explore the prevention of lower limbs deep vein thrombosis（DVT） after hip arthroplasty. Methods Totally 105 patients with artificial hip joint replacement in our hospital from February 2010 to August 2013 were divided into three groups with 35 cases in each group. For the prevention of postoperative lower limbs deep venous thrombs, those groups were used mechanical prevention, drug prevention or mechanical and drug combination prevention methods separately. The serum D-dimer concentrations of three groups were analyzed at the different time points preoperatively and postoperatively and were compared. At the same time, the incidence of deep venous thrombosis were detected through color doppler ultrasound. Results About the average concentration of serum D-dimer at 3 days, 7 days and 14 days postoperative, the three groups were machinery group, drug group and the combination group from high to low. The incidences of postoperative DVT in the three groups were 31.4%, 20% and 8.7%, respectively, with a statistically significant difference（P〈0.05）. Conclusion For the prevention of deep venous thrombosis after hip arthroplasty, mechanical and drug taking combination method is much better than single mechanical prevention or drug prevention method.