中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2014年
2期
18-20
,共3页
髋关节%关节成形术,置换,髋%血栓形成%治疗结果
髖關節%關節成形術,置換,髖%血栓形成%治療結果
관관절%관절성형술,치환,관%혈전형성%치료결과
Hip jiont%Arthroplasty,replacement,hip%Thrombosis%Treatment outcome
目的 探讨全髋关节置换术围手术期深静脉血栓形成(DVT)的治疗措施.方法 回顾性分析300例行人工全髋关节置换术患者的临床资料.所有患者入院时均常规检测凝血功能,术后第1,3,5天监测D-二聚体(D-D)水平.疑似DVT患者,行下肢彩色多普勒超声检查,诊断不明确时行静脉造影.全部患者均接受物理治疗和预防性抗凝治疗.结果 术前共诊断DVT20例(30侧肢体),中心型7例,周围型13例.所有患者进行术前抗凝治疗后,非DVT患者D-D水平呈逐渐下降趋势;DVT患者第1天和第3天D-D仍维持在高水平状态,平均D-D分别为6500,6800 μg/L.其他280例全髋关节置换术病例中共发现40例DVT.其中周围型DVT患者术后继续抗凝治疗6个月,中心型或混合型DVT患者骨科手术后放置临时腔静脉滤器,所有患者围手术期均未出现严重并发症.结论 全髋关节置换术患者术前需要充分监测评估,术后需早期进行功能锻炼,并联合抗凝治疗预防DVT.
目的 探討全髖關節置換術圍手術期深靜脈血栓形成(DVT)的治療措施.方法 迴顧性分析300例行人工全髖關節置換術患者的臨床資料.所有患者入院時均常規檢測凝血功能,術後第1,3,5天鑑測D-二聚體(D-D)水平.疑似DVT患者,行下肢綵色多普勒超聲檢查,診斷不明確時行靜脈造影.全部患者均接受物理治療和預防性抗凝治療.結果 術前共診斷DVT20例(30側肢體),中心型7例,週圍型13例.所有患者進行術前抗凝治療後,非DVT患者D-D水平呈逐漸下降趨勢;DVT患者第1天和第3天D-D仍維持在高水平狀態,平均D-D分彆為6500,6800 μg/L.其他280例全髖關節置換術病例中共髮現40例DVT.其中週圍型DVT患者術後繼續抗凝治療6箇月,中心型或混閤型DVT患者骨科手術後放置臨時腔靜脈濾器,所有患者圍手術期均未齣現嚴重併髮癥.結論 全髖關節置換術患者術前需要充分鑑測評估,術後需早期進行功能鍛煉,併聯閤抗凝治療預防DVT.
목적 탐토전관관절치환술위수술기심정맥혈전형성(DVT)적치료조시.방법 회고성분석300례행인공전관관절치환술환자적림상자료.소유환자입원시균상규검측응혈공능,술후제1,3,5천감측D-이취체(D-D)수평.의사DVT환자,행하지채색다보륵초성검사,진단불명학시행정맥조영.전부환자균접수물리치료화예방성항응치료.결과 술전공진단DVT20례(30측지체),중심형7례,주위형13례.소유환자진행술전항응치료후,비DVT환자D-D수평정축점하강추세;DVT환자제1천화제3천D-D잉유지재고수평상태,평균D-D분별위6500,6800 μg/L.기타280례전관관절치환술병례중공발현40례DVT.기중주위형DVT환자술후계속항응치료6개월,중심형혹혼합형DVT환자골과수술후방치림시강정맥려기,소유환자위수술기균미출현엄중병발증.결론 전관관절치환술환자술전수요충분감측평고,술후수조기진행공능단련,병연합항응치료예방DVT.
Objective To explore the treatment measures of peroperative period deep vein thrombosis (DVT) after total hip replacement.Methods The clinical data of 300 patients who were treated by total hip replacement were analyzed retrospectively.All patients were given conventional detection of coagulation status.The level of D-dimer (D-D) was detected after operation for 1,3,5 d.The patients who suspected with DVT were checked lower limb by color Doppler ultrasonography.If the diagnosis was not clear,the venography was took.All patients were treated with physical therapy and anticoagulation therapy.Results Twenty patients (30 limbs) were diagnosed with DVT before operation,7 patients were central type,13 patients were peripheral type.All patients underwent preoperative anticoagulation,the level of D-D in non-DVT patients was decreased.The level of D-D in DVT patients in the first and third day kept at high level and were 6500,6800 μ g/L.After operation,40 patients were diagnosed with DVT.The peripheral type DVT patients were treated with continued anticoagulation for 6 months,the central type or mixed type DVT patients were treated by temporary vena cava filter,all patients had no severe complications during peroperative period.Conclusions The operation of total hip replacement need sufficient assessment and monitoring during peroperative period.Postoperative early functional exercise and anticoagulation therapy may be given to prevent DVT.
