Zhang Haojun, Mao Ping, Wang Chao, Chen Dongyang, Xu Zhihong, Shi Dongquan, Dai Jin, Yao Yao, Jiang Qing
aDepartment of Sports Medicine and Adult Reconstructive Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University bDepartment of Sports Medicine and Adult Reconstructive Surgery, Nanjing Drum Tower Hospital Affiliated to Medical School of Nanjing University, Nanjing, Jiangsu cLaboratory for Bone and Joint Diseases, Model Animal Research Center, Nanjing University, Nanjing, Jiangsu, PR China.
Blood Coagul Fibrinolysis. 2017 Mar;28(2):126-133. doi: 10.1097/MBC.0000000000000556.
Deep vein thrombosis (DVT) after total hip or knee arthroplasty is relatively common and is associated with significant morbidity and mortality, presenting a large clinical burden. The objective of this study was to investigate the incidence and risk factors for DVT after total joint arthroplasty. This retrospective review was conducted in a single institution. The patients received postoperative DVT chemoprophylaxis (Fraxiparine or Rivaroxaban), followed by venography to check for DVT on the third to ninth postoperative day. The clinical characteristics were summarized and analyzed using SPSS version 17.0. From March 2010 to July 2013, 963 patients were enrolled in the study. DVT chemoprophylaxis was administered to all of the 963 patients. DVT occurred in 173 subjects (17.96%). Univariate analysis showed that age (P < 0.001), BMI (P < 0.01), cholesterol (P < 0.001), high-density lipoprotein (P < 0.001), apolipoprotein A (P < 0.01), history of tumor (P < 0.05), visual analogue scale (VAS) pain score (P < 0.001), and operative duration (P < 0.05) were significant risk factors for DVT. The incidence of DVT was 17.96% after total joint arthroplasty with prophylactic antithrombotic therapy. Age, BMI, cholesterol, high-density lipoprotein, apolipoprotein A, history of tumor, VAS score, and operative duration were significant risk factors for DVT.
全髋关节或膝关节置换术后深静脉血栓形成（DVT）相对常见，且与显著的发病率和死亡率相关，带来了巨大的临床负担。本研究的目的是调查全关节置换术后DVT的发生率及危险因素。本回顾性研究在单一机构进行。患者术后接受DVT化学预防（法安明或利伐沙班），随后在术后第3至9天进行静脉造影检查DVT。使用SPSS 17.0版本对临床特征进行总结和分析。2010年3月至2013年7月，963例患者纳入本研究。963例患者均接受了DVT化学预防。173例患者（17.96%）发生DVT。单因素分析显示，年龄（P<0.001）、体重指数（BMI）（P<0.01）、胆固醇（P<0.001）、高密度脂蛋白（P<0.001）、载脂蛋白A（P<0.01）、肿瘤病史（P<0.05）、视觉模拟评分（VAS）疼痛评分（P<0.001）和手术时长（P<0.05）是DVT的显著危险因素。全关节置换术后采用预防性抗血栓治疗，DVT的发生率为17.96%。年龄、BMI、胆固醇、高密度脂蛋白、载脂蛋白A、肿瘤病史、VAS评分和手术时长是DVT的显著危险因素。
