CAJ | 학술논문

目的分析髋、膝关节矫形术和髋部骨折内固定术后病人下肢深静脉血栓形成(DVT)的危险因素.方法 2004年至2005年接受髋、膝关节矫形术和髋部骨折内固定术的病人147例,年龄33～92岁.术后2周行双侧下肢静脉Duplex彩色超声检查,观察DVT形成的情况,根据是否形成DVT,分为非DVT组和DVT组.记录围术期有关病人、手术和麻醉方面的临床资料.结果术后下肢DVT发生率42.2%,而近端DVT发生率2.7%.与非DVT组相比,DVT组麻黄碱使用率及其用量增加,麻醉时间延长,术后1 d白细胞计数及术后最高白细胞计数明显升高(P＜0.05);logistic回归分析结果显示,上述因素与下肢DVT有关(P＜0.05).结论髋、膝关节矫形和髋部骨折内固定术后病人下肢DVT的危险因素为麻醉时间＞3 h、使用麻黄碱及术后白细胞计数明显升高.
목적 분석관、슬관절교형술화관부골절내고정술후병인하지심정맥혈전형성(DVT)적위험인소.방법 2004년지2005년접수관、슬관절교형술화관부골절내고정술적병인147례,년령33～92세.술후2주행쌍측하지정맥Duplex채색초성검사,관찰DVT형성적정황,근거시부형성DVT,분위비DVT조화DVT조.기록위술기유관병인、수술화마취방면적림상자료.결과 술후하지DVT발생솔42.2%,이근단DVT발생솔2.7%.여비DVT조상비,DVT조마황감사용솔급기용량증가,마취시간연장,술후1 d백세포계수급술후최고백세포계수명현승고(P＜0.05);logistic회귀분석결과현시,상술인소여하지DVT유관(P＜0.05).결론 관、슬관절교형화관부골절내고정술후병인하지DVT적위험인소위마취시간＞3 h、사용마황감급술후백세포계수명현승고.
Objective To determine the factors which contribute to development of deep vein thrombosis (DVT)in lower extremity in patients after hip or knee arthroplasty and hip fracture internal Fixation.Methods One hundred forty seven consecutive patients receiving hip or knee arthroplasty and hip fracture internal fixation from 2004 to 2005 were included in this study.Their age ranged from 33 to 92 yr.Bilateral lower extremity vein Duplex color ultrasound was performed before and 2 weeks after operation for detection of DvT.The patients were divided into DVT and DVT-free groups based on the development of DVT after operation.Detailed perioperative clinical information about the patients,surgery and anesthesia was collected.Results Lower extremity DVT was found in 42.2% of the patients after operation.The incidence of proximal DVT was 2.7%.The rate of ephedrine administration was significantly higher and the amount of ephedrine given was larger in DVT group than in DVT-free group.Duration of anesthesia was significantly longer and WBC count on the 1st postoperative day was significantly higher in DVT group than in DVT-free group(P＜0.05).Logistic analysis indicated that the above factors were closely related to DVT.Conelusion Duration of anesthesia＞3 h,ephedrine administration and marked increase in WBC count after operation are the risk factors for DVT in lower extremity after hip or knee arthroplasty and hip fracture internal fixation.