CAJ | 학술논문

目的：分析人工髋关节置换术后，患者出现下肢深静脉血栓（DVT）的影响因素。方法选取我院2010年2月至2012年1月收治92例进行髋关节置换手术的患者作为观察对象，全部患者于术前7 d及术后7 d行血管彩超（双下肢），分析年龄、性别、BMI、激素应用、TG、糖尿病、高血压等15项因素与术后DVT发生的相关性。结果血管彩超结果显示，92例患者中，28例患者于术后发现DVT（30.43%），血栓均分布在患者小腿肌间。其中，13例患者（46.43%）无相关临床症状。女性、肥胖、高龄、O型血、高血压、糖尿病、总输血量大、胆固醇及三酰甘油高是DVT发生的危险因素，RR值＞1。其中，患者年龄＞65岁，大量输血，TG水平高（≥1.7 mmol/L）与DVT发生密切相关，P<0.05，具统计学意义。结论患者年龄＞65岁，大量输血、TG水平高是诱发术后DVT的重要因素。因此，在髋关节置换术后，我们应严格控制患者输血量；若患者需要大量输血，我们可采用少量多次的方法补充血液；此外，DVT还应引起B超医师及临床医师的足够重视。
목적：분석인공관관절치환술후，환자출현하지심정맥혈전（DVT）적영향인소。방법선취아원2010년2월지2012년1월수치92례진행관관절치환수술적환자작위관찰대상，전부환자우술전7 d급술후7 d행혈관채초（쌍하지），분석년령、성별、BMI、격소응용、TG、당뇨병、고혈압등15항인소여술후DVT발생적상관성。결과혈관채초결과현시，92례환자중，28례환자우술후발현DVT（30.43%），혈전균분포재환자소퇴기간。기중，13례환자（46.43%）무상관림상증상。녀성、비반、고령、O형혈、고혈압、당뇨병、총수혈량대、담고순급삼선감유고시DVT발생적위험인소，RR치＞1。기중，환자년령＞65세，대량수혈，TG수평고（≥1.7 mmol/L）여DVT발생밀절상관，P<0.05，구통계학의의。결론환자년령＞65세，대량수혈、TG수평고시유발술후DVT적중요인소。인차，재관관절치환술후，아문응엄격공제환자수혈량；약환자수요대량수혈，아문가채용소량다차적방법보충혈액；차외，DVT환응인기B초의사급림상의사적족구중시。
Objective To analysis after hip arthroplasty in patients with lower extremity deep vein thrombosis (DVT) of influencing factors. Method Select our hospital in February 2010 to January 2012 92 cases of hip replacement surgery in our hospital patients as research object. All patients in the preoperative to exceed 7 d and 7 d after operation and vessels (double lower limbs), the analysis of age, gender, BMI, diabetes, high blood pressure, hormone application and TG correlation factors and postoperative DVT. Results Vascular ultrasound to exceed, according to the results of 92 patients, 28 cases was found in postoperative patients with DVT (30.43%), blood clots are distributed between the calf muscle in patients. Among them, 13 patients (46.43%), no related to clinical symptoms. Women, obesity, older age, type O blood, hypertension, diabetes, blood transfusion volume, high cholesterol and triglycerides are a risk factor for DVT occurs, the RR values greater than 1. Among them, the patients older than 65 years, a large number of blood transfusions, high TG level (not less than 1.7 tendency/L) are closely related to DVT occurrence, P<0.05, with statistical significance. Conclusion Patients older than 65 years old, high TG levels, total blood volume are one of the important factors that induce postoperative DVT. After hip replacement, therefore, we should strictly control the amount of blood transfusion;if patients need a lot of blood transfusion, we can adopt the method of repeated small added blood;moreover, DVT should also cause the ultrasound doctors and clinicians.