CAJ | 학술논문

目的：探讨人工关节置换术后围手术期重要器官栓塞的危险因素，为降低其发生率提供依据。方法对1285例接受人工关节置换术患者的临床资料进行回顾性分析，根据是否发生栓塞将患者分为栓塞组和未栓塞组。选取性别、年龄、吸烟、饮酒、感染、心脏病、高血压、糖尿病、深静脉血栓形成、使用骨水泥、使用止血带作为围手术期重要器官栓塞的可能影响因素，采用单因素分析进行筛选，采用Logistic回归分析确定危险因素。结果发生器官栓塞15例（1．17％），其中脑栓塞3例，肺栓塞12例。糖尿病（ P ＝0．020、OR ＝4．778、95％ CI ＝1．275～17．904）、深静脉血栓形成（P ＝0．029、OR ＝4．098、95％ CI ＝1．156～14．541）、年龄（P ＝0．029、OR ＝2．944、95％ CI ＝1．119～7．752）、心脏病（P ＝0．031、OR ＝3．930、95％ CI＝1．134～13．626）、使用骨水泥（P ＝0．036、OR ＝3．870、95％ CI ＝1．095～13．667）与使用止血带（P＝0．041、OR ＝4．052、95％ CI ＝1．062～15．456）是围手术期发生器官栓塞的危险因素。结论糖尿病、深静脉血栓形成、年龄、心脏病、使用骨水泥、使用止血带可能是人工关节置换术后围手术期重要器官栓塞的独立危险因素，控制危险因素有助于降低器官栓塞发生率。
목적：탐토인공관절치환술후위수술기중요기관전새적위험인소，위강저기발생솔제공의거。방법대1285례접수인공관절치환술환자적림상자료진행회고성분석，근거시부발생전새장환자분위전새조화미전새조。선취성별、년령、흡연、음주、감염、심장병、고혈압、당뇨병、심정맥혈전형성、사용골수니、사용지혈대작위위수술기중요기관전새적가능영향인소，채용단인소분석진행사선，채용Logistic회귀분석학정위험인소。결과발생기관전새15례（1．17％），기중뇌전새3례，폐전새12례。당뇨병（ P ＝0．020、OR ＝4．778、95％ CI ＝1．275～17．904）、심정맥혈전형성（P ＝0．029、OR ＝4．098、95％ CI ＝1．156～14．541）、년령（P ＝0．029、OR ＝2．944、95％ CI ＝1．119～7．752）、심장병（P ＝0．031、OR ＝3．930、95％ CI＝1．134～13．626）、사용골수니（P ＝0．036、OR ＝3．870、95％ CI ＝1．095～13．667）여사용지혈대（P＝0．041、OR ＝4．052、95％ CI ＝1．062～15．456）시위수술기발생기관전새적위험인소。결론당뇨병、심정맥혈전형성、년령、심장병、사용골수니、사용지혈대가능시인공관절치환술후위수술기중요기관전새적독립위험인소，공제위험인소유조우강저기관전새발생솔。
Objective To approach the risk factor of critical organ embolic in perioperative period after arti-ficial joint replacement in order to provide a basis to reduce its incidence .Methods T he clinical data of 214 patients who received artificial joint replacement surgery were retrospectively analyzed and patients were divided into embolic group and non-embolic group on according to whether or not embolize .The gender , age ,smoking ,alcohol consumption ,infections ,heart disease ,hypertension ,diabetes ,deep vein thrombo-sis ,the use of bone cement ,the use of a tourniquet were seen as the possible influencing factor of critical organ embolic in perioperative period .Screening was completed with single factor analysis and risk factors were definited with Logistic regression analysis .Results Of fifteen organ embolism (7 .0% ) ,three cases experienced cerebral embolism and twelve cases experienced lung embolism .Diabetes (P = 0 .020 ,OR =4 .778 ,95% CI =1 .275-17 .904) ,deep venous thrombosis (P= 0 .029 ,OR =4 .098 ,95% CI =1 .156-14 .541) ,age (P = 0 .029 ,OR = 2 .944 ,95% CI = 1 .119 -7 .752) ,heart disease (P = 0 .031 ,OR =3 .930 ,95% CI =1 .134-13 .626) ,the use of bone cement (P = 0 .036 ,OR =3 .870 ,95% CI =1 .095-13 .667) ,the use of a tourniquet (P = 0 .041 ,OR =4 .052 ,95% CI =1 .062-15 .456) were the risk fac-tors of organ embolism in perioperative period .Conclusion Diabetes ,deep venous thrombosis ,age ,heart disease ,the use of bone cement and the use of a tourniquet may be the independence risk factors of critical organ embolic in perioperative period after artificial joint replacement and controlling risk factors can con-duce to reduce the incidence of organ embolism .