全髋关节置换术围手术期深静脉血栓防治的临床探讨

Clinical Discussion on the Prevention and Treatment of Perioperative Deep Vein Thrombosis in Total Hip Replacement

目的探讨全髋关节置换术围手术期深静脉血栓防治方法及临床疗效。方法选取2015年8月至2017年5月期间行全髋关节置换术治疗的82例患者,随机分为对照组和观察组,各41例。对照组常规采用药物预防性抗凝治疗,观察组采用围术期综合性预防模式。比较两组患者手术前后的血浆D-二聚体(D-D)水平和术后深静脉血栓发生率。结果观察组的术后深静脉血栓发生率为7.32%,显著低于对照组的24.39%(P<0.05)。观察组术后第1 d、3 d、5 d、7 d、14 d的血浆D-D水平均显著低于对照组(P<0.05)。结论在全髋关节置换术围手术期采取深静脉血栓综合性预防治疗,可有效降低深静脉血栓形成风险,临床应用价值较高。

Objective To explore the prevention and treatment ofperioperative deep vein thrombosis in total hip replacement and the clinical curative effect. Methods 82 cases of patients undergoing total hip replacement from August 2015 to May 2017 were selected and randomly divided into control group and observation group, with 41 cases in each group. The control group received conventional drug preventive anticoagulant therapy, while the observation group was given comprehensive preventive mode during perioperative period. The plasma D-dimer （D-D） levels and incidence of postoperative deep vein thrombosis before and after operation were compared between two groups. Results The incidence of postoperative deep vein thrombosis of observation group was 7.32%, significantly lower than 24.39% of control group （P〈0.05）. The D-D levels of observation group at 1 d, 3 d, 5 d, 7 d and 14 d after operation were significantly lower than those of control group （P 〈0.05）. Conclusions The comprehensive prevention and treatment of deep vein thrombosis during the perioperative period of total hip replacement can effectively reduce the risk of deep vein thrombosis, which has higher clinical value.