Yoo Myung-Chul, Cho Yoon-Je, Ghanem Elie, Ramteke Alankar, Kim Kang-Il
Department of Orthopaedic Surgery, Center for Joint Diseases, Kyung Hee University East-West Neo Medical Center, 149 Sangil-dong, Gangdong-gu, Seoul, 134-727, South Korea.
Arch Orthop Trauma Surg. 2009 Jul;129(7):887-94. doi: 10.1007/s00402-008-0751-2. Epub 2008 Sep 30.
This prospective study was designed to confirm risk factors and to assess the incidence of deep vein thrombosis after total hip and surface replacement arthroplasty in Korean patients not receiving anticoagulation prophylaxis and to determine efficacy of plasma D-dimer levels as a screening test.
From May 2003 to August 2004, 221 consecutive patients undergoing unilateral total hip arthroplasty and hip resurfacing were evaluated. All patients underwent ultrasonography preoperatively and venography and/or ultrasonography on postoperative day 7. Plasma D-dimer levels were estimated by latex immuno-assay preoperatively and on days 3 and 7 postoperatively.
Of the 221 patients in our cohort, 23 developed deep vein thrombosis (10.4%). Age (r = 0.245, P < 0.001) and gender (r = 0.155, P = 0.021) significantly correlated with deep vein thrombosis. Rise in incidence paralleled increase in age (X(2) = 32.860, P < 0.001). D-dimer levels on postoperative days 3 (gamma = 0.364, P < 0.001) and 7 (gamma = 0.470, P < 0.001) were significantly correlated to the development of DVT.
While incidence of deep vein thrombosis in Korean population after THA was lower than that in the West; it increased with age, and in female gender. Significant correlation was found between D-dimer levels and the development of deep vein thrombosis.
本前瞻性研究旨在确定韩国未接受抗凝预防的患者在全髋关节置换术和表面置换术后深静脉血栓形成的危险因素及发生率，并确定血浆D - 二聚体水平作为筛查试验的有效性。
2003年5月至2004年8月，对221例连续接受单侧全髋关节置换术和髋关节表面置换术的患者进行评估。所有患者术前均接受超声检查，术后第7天接受静脉造影和/或超声检查。术前及术后第3天和第7天通过乳胶免疫测定法评估血浆D - 二聚体水平。
在我们队列中的221例患者中，23例发生深静脉血栓形成（10.4%）。年龄（r = 0.245，P < 0.001）和性别（r = 0.155，P = 0.021）与深静脉血栓形成显著相关。发病率的上升与年龄的增加平行（X(2)= 32.860，P < 0.001）。术后第3天（γ = 0.364，P < 0.001）和第7天（γ = 0.470，P < 0.001）的D - 二聚体水平与深静脉血栓形成的发生显著相关。
虽然韩国人群全髋关节置换术后深静脉血栓形成的发生率低于西方；但它随年龄增长和女性性别而增加。发现D - 二聚体水平与深静脉血栓形成的发生之间存在显著相关性。
