Lim Hee Joong, Jeon Ji Young, Jeong Yu Mi, Lee Beom Gu, Sim Jae-Ang, Lee Sheen-Woo
Department of Radiology, Gachon University Medical Center, Gachon University College of Medicine, Incheon, Korea.
Department of Orthopedic Surgery, Gachon University Medical Center, Gachon University College of Medicine, Incheon, Korea.
Ultrasonography. 2021 Jul;40(3):442-448. doi: 10.14366/usg.20171. Epub 2021 Jan 12.
This study aimed to stratify risk factors and vein levels for postoperative deep vein thrombosis (DVT) after lower-extremity orthopedic surgery.
Ninety-nine patients who underwent Doppler ultrasonography after lower-extremity orthopedic surgery were enrolled. Medical records were reviewed for anesthesia duration, type of surgery, body weight, height, and cardiovascular risk factors (including history of smoking, diabetes mellitus or hypertension, blood pressure, and total cholesterol and high-density lipoprotein [HDL] cholesterol levels), and the DVT treatment. Ultrasound diagnosis of DVT was made according to a routine protocol. The relationships between selected factors and the presence of DVT were assessed using univariate and multivariate regression analyses.
Thirty-three (33%) patients were found to have calf DVT. The mean age, weight, and height of the non-DVT and postoperative DVT patients were 55.1 years versus 65.4 years, 70.5 kg versus 61.2 kg, and 163.3 cm versus 157.0 cm, respectively. Total cholesterol/HDL levels in the non-DVT and DVT patients were 70.6/20.7 mg/dL and 90.8/26.0 mg/dL, retrospectively. Systolic and diastolic blood pressure in the non-DVT and DVT patients were 133.6/80.2 mm Hg and 132.2/78.1 mmHg, respectively. The mean duration of anesthesia was 173.9 versus 199.9 minutes, and the operative time was 136.4 minutes versus 161.0 minutes. Older age (P=0.005) and lower body weight (P=0.002) were significantly associated with postoperative DVT. No other significant between-group differences were found (P>0.05). The patients with ultrasound-identified DVT received antithrombotic treatment. None of them had distant thromboembolism.
After lower-extremity orthopedic surgery, the calf veins in elderly patients with low body weight are susceptible to thrombosis; they would most likely benefit from postoperative ultrasonography.
本研究旨在对下肢骨科手术后深静脉血栓形成（DVT）的危险因素和静脉水平进行分层。
纳入99例下肢骨科手术后接受多普勒超声检查的患者。查阅病历以获取麻醉持续时间、手术类型、体重、身高和心血管危险因素（包括吸烟史、糖尿病或高血压病史、血压以及总胆固醇和高密度脂蛋白[HDL]胆固醇水平），以及DVT治疗情况。根据常规方案进行DVT的超声诊断。使用单因素和多因素回归分析评估所选因素与DVT存在之间的关系。
33例（33%）患者被发现有小腿DVT。非DVT患者和术后DVT患者的平均年龄、体重和身高分别为55.1岁对65.4岁、70.5 kg对61.2 kg、163.3 cm对157.0 cm。回顾性分析显示，非DVT患者和DVT患者的总胆固醇/HDL水平分别为70.6/20.7 mg/dL和90.8/26.0 mg/dL。非DVT患者和DVT患者的收缩压和舒张压分别为133.6/80.2 mmHg和132.2/78.1 mmHg。平均麻醉持续时间为173.9分钟对199.9分钟，手术时间为136.4分钟对161.0分钟。年龄较大（P = 0.005）和体重较低（P = 0.002）与术后DVT显著相关。未发现其他显著的组间差异（P>0.05）。超声确诊为DVT的患者接受了抗血栓治疗。他们均未发生远处血栓栓塞。
下肢骨科手术后，体重低的老年患者小腿静脉易发生血栓形成；他们很可能从术后超声检查中获益。
