人工全髋关节置换术后下肢深静脉血栓形成的高危因素

High risk factors of deep venous thrombosis after total hip replacement

目的探讨人工全髋关节置换术后患者发生下肢深静脉血栓形成的高危因素。方法回顾性分析328例行人工全髋关节置换术患者的临床资料。其中60例患者术后发生下肢深静脉血栓,268例无下肢深静脉血栓。采用单因素和多因素分析术后下肢深静脉血栓形成的高危因素。结果单因素分析显示,年龄大、吸烟时间长、术前下肢静脉有病变者、有糖尿病病史、有高血压病史、术前体质量指数>27 kg/m2、术中失血量>500 m L、术后未进行下肢辅助锻炼、术后卧床时间>4 d、血液高凝、有心房颤动史、合并肺部感染是患者术后出现下肢深静脉血栓的单因素危险因素。多因素分析结果显示:年龄、术前下肢病变、术中失血量>500 m L、血液高凝、高血压病史、心房颤动病史、肺部感染是患者术后下肢深静脉血栓形成的独立危险因素。结论人工全髋关节置换术后患者发生下肢深静脉血栓形成的高危因素较多,因此应重视这些高危因素。

Objective To explore the high risk factors of deep venous thrombosis after total hip replacement. Methods Three hundreds and twenty-eight patients with total hip replacement in our hospital from January 2012 to January 2016 were retrospectively analyzed. Sixty patients had deep venous thrombosis after total hip replacement, and 268 patients without deep venous thrombosis. The high risk factors of deep venous thrombosis after total hip replacement were investigated by univariate and multivariate analysis. Results The univariate analysis showed older, long-term smoking,lower extremity venous disease,diabetes history,hypertension history, BMI 〉27 kg/m2 , intraoperative blood loss 〉 500 ml, without postoperative lower limb exercise, preoperative bed time 〉 4 days, hypercoagulability, atrial fibrillation history, and lung infection were the high risk factors of deep venous thrombosis after total hip replacement. The multivari-ate analysis showed that older,lower extremity venous diease, hypertension history, intraoperative blood loss 〉500 mL, hypercoagulability,atrial fibrillation history,and lung infection were independent risk factors of deep venous thrombosis after total hip replacement . Conclusions There are many risk factors of deep venous thrombosis after total hip replace-ment, therefore, more attention should be paid to those risk factors.