不同季节膝关节置换术后下肢深静脉血栓形成发生率的差异

Difference in the incidences of deep venous thrombosis of lower extremities after arthroplasty in different seasons

目的探讨不同季节膝关节置换术后下肢深静脉血栓(DVT)形成发生率的差异。方法回顾性分析行人工膝关节置换手术的566例患者的临床资料,采用logistic回归分析下肢DVT形成的危险因素。结果 566例人工膝关节置换手术患者共发生下肢DVT 114例,发病率为20.14%。单因素分析结果显示,不同年龄、体重指数、麻醉方式和发病季节、是否静脉曲张和静脉血栓史患者的下肢DVT发生率比较,差异均有统计学意义(χ2分别=5.38、5.03、6.96、8.77、9.53、5.15,P均<0.05)。logistic回归分析结果显示,年龄≥60岁、BMI≥25 kg/m2、全身麻醉、合并静脉曲张、合并静脉血栓史和秋冬季节是膝关节置换术后下肢深静脉血栓形成的危险因素(OR分别=3.31、1.17、2.54、3.61、2.20、2.37,P均<0.05)。12月至2月份是膝关节置换术患者下肢DVT发生率较高的月份。结论不同季节人工膝关节置换术患者下肢DVT发生率不同,其中秋冬季发生率较高。

Objective To investigate the difference in the incidences of deep venous thrombosis（DVT）after lower limbknee arthroplasty in different seasons.Methods The clinical data of 566 patients undergoing artificial knee replacementsurgery were retrospectively analyzed,and the risk factors of DVT in the lower limb were analyzed by using logisticregression analysis.Results A total of 114 cases occurred DVT in the lower limb in 566 patients who underwent kneereplacement surgery.The morbidity was 20.14%.The univariate analysis showed that the incidences of DVT in lower limbbetween patients with different ages,body mass index,anesthesia patterns,onset seasons,whether varicose veins andvenous thrombosis were statistically different（χ2 = 5.38,5.03,6.96,8.77,9.53,5.15,P〈0.05）.Logistic regressionanalysis showed that age≥60 years old,BMI≥25 kg/m2,general anesthesia,combining with varicose veins,history ofvenous thrombosis,and autumn/winter seasons were risk factors for deep venous thrombosis after knee replacement（OR=3.31,1.17,2.54,3.61,2.20,2.37,P〈0.05）.December,January,February were the months with a higher incidence ofDVT in lower limb.Conclusions The incidences of DVT in lower limb in patients who underwent artificial knee jointreplacement are different in different seasons,especially with a higher incidence in autumn and winter.