12例髋关节置换术后下肢静脉血栓形成临床分析

Clinical analysis of Deep Venous Thrombosis of Lower extremity after Hip Joint Replacement with 12 patients

目的对12例髋关节置换术后发生下肢深静脉血栓的患者进行临床分析。方法近五年来,北京市朝阳区小红门社区卫生服务中心和北京市朝阳区八里庄第二社区卫生服务中心病房接收大医院转来的髋关节置换术后进行康复治疗的患者,12例患者在康复治疗期间发生下肢静脉血栓,回顾分析12例患者临床资料,分析其发生原因及其危险因素。结果8例髋关节置换患者年龄大于72岁,发生周围型深静脉血栓9例,中央型深静脉血栓3例,这3例患者均在抗凝治疗情况下1-2周内由周围型深静脉血栓发展至中央型深静脉血栓,转院后均经检查诊断为肺栓塞,均行腔静脉滤网,2例存活,1例抢救无效死亡。所有患者入院时D二聚体正常,发生下肢静脉血栓时D二聚体明显升高。结论髋关节置换术是治疗髋关节骨折的一种有效治疗方法,但高龄患者及其合并症、D二聚体是髋关节置换术后下肢深静脉血栓形成的独立危险因素。

Objective Clinical analysis of prevention of deep venous thrombosis of lower extremity after Hip Joint replacement with 12 cases.Methods 12 patients with Hip Joint replacement from two Community Health Service Centers were enrolled in this study.The clinical data were retrospectively analyzed.Results 8 patients with hip arthroplasty were older than 72 years old,9 had peripheral deep vein thrombosis,and 3 had central deep vein thrombosis.These three patients developed from peripheral deep vein thrombosis to central deep vein thrombosis within 1-2 weeks under the condition of anticoagulation treatment.After transfer,pulmonary embolism was diagnosed by examination,and vena cava filter was used.Two patients survived,and one died after rescue.All patients were normal at the time of admission,The D-dimer was significantly increased when the lower extremity venous thrombosis occurred.Conclusion Hip arthroplasty is an effective treatment for hip joint disease.Older age,combination of basic diseases,D-dimer and Older age are independent rist factors of deep venous thrombosis of lower extremity after Hip.