初次髋膝关节置换术后静脉血栓发生情况的分析

Analysis of Occurrence of Venous Thrombosis after Primary Hip and Knee Joint Replacement

目的初次髋膝关节置换术后静脉血栓发生情况的分析。方法选取该院2014年3月—2018年3月共862例初次髋膝关节置换术患者作为研究对象,其中髋关节置换术(THA)474例,膝关节置换术(TKA)388例。分析术后静脉血栓的发生情况。结果 474例THA患者中,共出现15例血栓,其中13例为孤立性肌间静脉血栓,另外2例为累及腓静脉或胫后静脉的周围性血栓,未出现中心性血栓。388例TKA患者中,共出现45例血栓,其中42例为周围性血栓,2例中心型血栓,1例混合型血栓;其中38例血栓累及单支静脉,33例血栓累及肌间静脉,2例累及股静脉,2例累及胫后静脉,1例累及浅静脉;其中7例静脉累及多支静脉,包括肌间静脉、胫后静脉、腓静脉、腘静脉中的2~3支。款膝关节置换术后静脉血栓发生率对比差异有统计学意义(χ2=23.431,P=0.000),且膝关节置换术后更容易出现中心型以及多静脉受累的血栓。结论通过针对性的预防护理措施,能有效降低髋膝关节置换术后静脉血栓的发生率,但从整体来看,膝关节置换术后静脉血栓发生率相对较高。

Objective To analyze the incidence of venous thrombosis after primary hip and knee joint replacement.Methods A total of 862 primary hip and knee arthroplasty patients from March 2014 to March 2018 were selected as study subjects, including 474 hip arthroplasty（THA） and 388 knee arthroplasty（TKA）. Analyze the occurrence of postoperative venous thrombosis. Results Among the 474 THA patients, there were 15 cases of thrombosis, of which 13 cases were isolated intermuscular venous thrombosis, and the other 2 cases were peripheral thrombi involving the axillary vein or the posterior tibial vein. No central thrombosis occurred. In 388 patients with TKA, there were a total of 45 thrombi, of which 42 were peripheral thromboses, 2 were central thrombi, and 1 was mixed thrombosis; 38 of them involved single veins, 33 thrombi involving intermusclular veins, 2 cases involving the femoral vein, 2 cases involving the posterior tibial vein, 1 case involving the superficial vein; 7 of them involved multiple veins, including 2 to 3 of the intermuscular vein, posterior tibial vein, iliac vein, iliac vein. There was a significant difference in the incidence of venous thrombosis after knee arthroplasty（χ^2=23.431, P=0.000）, and it was more prone to central and multivenular thrombosis after knee arthroplasty. Conclusion Through targeted preventive nursing measures, the incidence of venous thrombosis after hip and knee joint replacement can be effectively reduced, but overall, the incidence of venous thrombosis after knee joint replacement is relatively high.