髋、膝关节置换术后院内发生下肢深静脉血栓的高危因素分析

Analysis of High Risk Factors for Deep Venous Thrombosis of Lower Extremities in Hospital After Hip and Knee Arthroplasty

目的探析髋、膝关节置换术患者术后院内发生下肢深静脉血栓(DVT)的高危因素。方法在2016年3月—2018年7月期间于新乡市第一人民医院择取215例髋、膝关节置换术患者作为分析对象,依据患者是否发生下肢深静脉血栓将其分为DVT组(53例)与非DVT组(162例),分析患者的各项临床资料,探析引发DVT的危险因素。结果膝关节置换术患者的DVT发生率明显高于髋关节置换术患者。DVT组患者平均年龄、BMI指数、手术时间、术后48hD-Dimer水平均显著高于非DVT组,且DVT组中具有吸烟史、高血压病史、甘油三酯较高以及术中失血量≥500ml的患者显著多于非DVT组,差异存在统计学意义(P<0.05)。结论进行膝关节置换术的患者相比髋关节置换术患者更容易发生DVT,患者的年龄较大、体重过重、血脂较高、手术时间长、术中失血量≥500ml、术后48hD-Dimer水平高、高血压病史和吸烟史均是发生DVT的高危因素,在临床治疗中对于具有以上情况的患者应尤其警惕DVT的发生。

Objective To explore the high risk factors of deep venous thrombosis(DVT)of lower extremities after hip and knee arthroplasty. Methods 215 cases of hip and knee arthroplasty in the hospital from March,2016 to July,2018 were selected,and they were divided into DVT group(53 cases)and non-DVT group(162 cases)according to whether the patients had deep venous thrombosis of lower limbs or not. The clinical data of the patients were analyzed,and the risk factors of DVT were analyzed. Results The incidence of DVT in patients with knee arthroplasty was significantly higher than that in patients undergoing hip arthroplasty. The mean age of patients,BMI index,operation time and the level of D-Dimer 48 hours after operation were significantly higher in the DVT group than in the non-DVT group,and the patients with smoking history,hypertension history,high triglyceride and intraoper ative blood loss ≥ 500mL in the DVT group were significantly higher than those in the non-DVT group. The difference was statistically significant(P<0.05). Conclusion Patients undergoing knee arthroplasty are more likely to develop DVT than hip arthroplasty pa tients. Older age,overweight body weight,higher blood lipid,longer operation time,more than 500 ml blood loss during operation and higher D-Dimer level 48 hours after operation are all high risk factors. In clinical treatment,the occurrence of DVT should be es pecially vigilant to the patients with these conditions.