CAJ | 학술논문

背景：髋关节置换后的临床并发症深静脉血栓具有较高的发生率，并且深静脉血栓能够导致危及患者生命安全的肺栓塞以及远端深静脉的功能障碍，因此深静脉血栓出现对于逐渐增多的髋关节置换是一个极大的障碍。 　　目的：观察老年患者全髋关节置换后下肢深静脉血栓的发生情况，筛选下肢出现深静脉血栓的危险因素。 　　方法：对128例髋关节置换老年患者临床资料进行回顾性分析，全部患者在置换前1 d及置换后的第7天分别进行双下肢的彩超检查，将患者下肢是否发生深静脉血栓与临床的可疑因素予以Logistic非条件多因素分析。 　　结果与结论：在置换后的第7天出现下肢深静脉血栓患者共16例，其中女性、全身麻醉、双侧髋关节置换、骨水泥的应用为下肢深静脉血栓出现的显著因素，其P值<0.05，能够导致70岁以上老年患者在实施全髋关节置换后出现深静脉血栓的风险呈显著性增加。Logistic非条件多因素的分析中显示性别、肥胖、骨水泥的使用3个因素在老年患者中深静脉血栓出现的风险倍数依次增加达11.398，3.109，8.925；患者血型为O型的70岁以上老年患者在实施全髋关节置换后出现深静脉血栓的风险则显著降低，在置换后出现深静脉血栓降低至0.186倍，能够被作为出现深静脉血栓的一项保护性因素。
배경：관관절치환후적림상병발증심정맥혈전구유교고적발생솔，병차심정맥혈전능구도치위급환자생명안전적폐전새이급원단심정맥적공능장애，인차심정맥혈전출현대우축점증다적관관절치환시일개겁대적장애。 　　목적：관찰노년환자전관관절치환후하지심정맥혈전적발생정황，사선하지출현심정맥혈전적위험인소。 　　방법：대128례관관절치환노년환자림상자료진행회고성분석，전부환자재치환전1 d급치환후적제7천분별진행쌍하지적채초검사，장환자하지시부발생심정맥혈전여림상적가의인소여이Logistic비조건다인소분석。 　　결과여결론：재치환후적제7천출현하지심정맥혈전환자공16례，기중녀성、전신마취、쌍측관관절치환、골수니적응용위하지심정맥혈전출현적현저인소，기P치<0.05，능구도치70세이상노년환자재실시전관관절치환후출현심정맥혈전적풍험정현저성증가。Logistic비조건다인소적분석중현시성별、비반、골수니적사용3개인소재노년환자중심정맥혈전출현적풍험배수의차증가체11.398，3.109，8.925；환자혈형위O형적70세이상노년환자재실시전관관절치환후출현심정맥혈전적풍험칙현저강저，재치환후출현심정맥혈전강저지0.186배，능구피작위출현심정맥혈전적일항보호성인소。
BACKGROUND:Deep vein thrombosis after hip replacement has a high incidence rate. Moreover, deep vein thrombosis can induce pulmonary embolism that can endanger patients’ life and dysfunction of distant deep vein. The appearance of deep vein thrombosis is a great obstacle for the gradual y increased hip replacement. OBJECTIVE:To observe the occurrence of deep vein thrombosis of lower limb after total hip replacement in elderly patients, and to screen the risk factors for the occurrence of deep vein thrombosis of lower limbs. METHODS:Clinical data of 128 elderly patients with hip replacement were analyzed retrospectively. Al patients were examined with color Doppler ultrasound in double lower limbs at 1 day before replacement and 7 days after replacement. Multifactor unconditional logistic analysis was conducted on clinical related factors and the formation of lower limb deep vein thrombosis. RESULTS AND CONCLUSION:At 7 days after the operation, 16 patients affected deep vein thrombosis of lower limb. The factors for deep vein thrombosis contained female, general anesthesia, bilateral hip replacement and the application of bone cement (P<0.05). The risk for deep vein thrombosis after total hip replacement significantly increased in elderly patients aged over 70 years. Multifactor unconditional logistic analysis exhibited that the multiple risks of sex, obesity and the use of bone cement in elderly patients with deep vein thrombosis increased to 11.398, 3.109 and 8.925. The patients with a blood type O at the age of over 70 years experienced a decreased risk for deep vein thrombosis after total hip replacement. The occurrence of deep vein thrombosis decreased to 0.186 times after replacement. Blood type O could be considered as a protective factor for the occurrence of deep vein thrombosis.