Xie Jin-Wei, Yue Chen, Ma Jun, Shen Bin, Yang Jing, Zhou Zong-Ke, Kang Peng-de, Pei Fu-Xing
Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.
Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China;
Zhongguo Gu Shang. 2016 Aug 25;29(8):708-712. doi: 10.3969/j.issn.1003-0034.2016.08.007.
To analyze the incidence and anatomic distribution of venous thrombosis after total hip and knee arthroplasty by using the data of the patients with primary total hip and knee replacement.
From December 2013 to December 2014, total hip and knee arthroplasty were performed in 1 686 patients, of which 928 were THA and 758 were TKA. Before and after discharge, all patients were routinely performed double lower limb vein color Doppler ultrasound, the conventional use of anti fibrinolytic drugs, postoperative anticoagulation for 14 d. The types and distribution of thrombosis after operation were statistical analysis.
Among 928 cases of primary total hip arthroplasty, there were 30 cases of thrombosis, 27 cases of isolated muscle vein thrombosis, followed by the involvement of the anterior or posterior tibial vein thrombosis, no central thrombosis. Among 758 cases of primary total knee arthroplasty, there were 87 cases of thrombosis, 81 cases peripheral thrombosis, 4 cases of thrombus of center type, the remaining 2 cases for mixed thrombus;74 patients with thrombosis involving a single vein, 65 cases involved muscle vein, 4 cases of femoral vein, 3 cases of posterior tibial vein, 2 cases of superficial vein; 13 cases of thrombosis involving multiple veins, involving muscle vein, posterior tibial veins, the peroneal veins and popliteal vein in 2 or 3 branches. The comparison results showed that the incidence of thrombosis after total knee arthroplasty was higher, the difference was statistically significant (<0.001), and more prone to central thrombosis and multiple venous involvement.
The incidence of thrombosis in patients with primary hip and knee replacement is low, and the incidence and anatomic distribution of the patients with primary hip and knee replacement are different.
通过使用初次全髋关节和膝关节置换患者的数据,分析全髋关节和膝关节置换术后静脉血栓形成的发生率及解剖分布情况。
2013年12月至2014年12月,对1686例患者进行了全髋关节和膝关节置换术,其中全髋关节置换术(THA)928例,全膝关节置换术(TKA)758例。出院前后,所有患者均常规行双下肢静脉彩色多普勒超声检查,常规使用抗纤溶药物,术后抗凝14天。对术后血栓形成的类型及分布进行统计学分析。
928例初次全髋关节置换术中,发生血栓形成30例,孤立性肌静脉血栓形成27例,其次为累及胫前或胫后静脉血栓形成,无中央型血栓形成。758例初次全膝关节置换术中,发生血栓形成87例,外周型血栓形成81例,中央型血栓形成4例,其余2例为混合型血栓形成;74例血栓形成累及单一静脉,其中累及肌静脉65例,股静脉4例,胫后静脉3例,浅静脉2例;13例血栓形成累及多条静脉,累及肌静脉、胫后静脉、腓静脉及腘静脉2或3支。比较结果显示,全膝关节置换术后血栓形成发生率较高,差异有统计学意义(<0.001),且更易发生中央型血栓形成及多静脉受累。
初次髋、膝关节置换患者血栓形成发生率较低,且初次髋、膝关节置换患者的发生率及解剖分布存在差异。