Sixth Afliated Hospital of Xinjiang Medical University, Orthopaedic Hospital of Xinjiang Uygur Autonomous Region, No.39 Wuxing Road, Urumqi, People's Republic of China.
Xinjiang Medical University, Xinjiang Uygur Autonomous Region, Urumqi, People's Republic of China.
BMC Surg. 2024 Sep 11;24(1):256. doi: 10.1186/s12893-024-02561-6.
To investigate the risk factors for deep vein thrombosis (DVT) following total hip arthroplasty (THA).
Patients who underwent THA in the Department of Joint Surgery at the Sixth Affiliated Hospital of Xinjiang Medical University from September 2020 to December 2022 were retrospectively selected based on inclusion criteria. They were divided into the DVT group (n = 65) and the non-DVT group (n = 397) according to the occurrence of postoperative DVT. The following variables were reviewed for both groups: age, sex, Body Mass Index (BMI), affected limb, previous history (smoking and drinking), diabetes, hypertension, operation time, total cholesterol, triglycerides, fibrinogen, hemoglobin, albumin, platelets, D-dimer, International Normalized Ratio (INR), and fibrin degradation products. Univariate analysis was conducted on these factors, and those with statistical significance were further analyzed using a binary logistic regression model to assess their correlation with DVT after THA.
A total of 462 patients were included in the study, with the DVT group representing approximately 14% and the non-DVT group approximately 86%. The DVT group had an average age of 67.27 ± 4.10 years, while the non-DVT group had an average age of 66.72 ± 8.69 years. Univariate analysis revealed significant differences in diabetes mellitus, preoperative fibrinogen, preoperative D-dimer, preoperative INR, and preoperative and postoperative fibrin degradation products between the DVT and non-DVT groups. Binary logistic regression analysis identified diabetes mellitus, elevated preoperative fibrinogen, preoperative D-dimer, and preoperative INR (p < 0.05) as risk factors for DVT after THA.
This study found that diabetes mellitus, elevated preoperative fibrinogen, preoperative D-dimer, and preoperative INR are independent risk factors for DVT following THA. Surgeons should thoroughly assess these risk factors, implement timely and effective interventions, and guide patients to engage in functional exercises as early as possible to reduce the incidence of DVT, thereby improving the outcomes of THA and improving patient quality of life.
探讨全髋关节置换术后深静脉血栓形成（DVT）的危险因素。
回顾性选取 2020 年 9 月至 2022 年 12 月在新疆医科大学第六附属医院关节外科行全髋关节置换术的患者，根据纳入标准选择病例。根据术后是否发生 DVT 将患者分为 DVT 组（n=65）和非 DVT 组（n=397）。回顾分析两组患者的年龄、性别、体质量指数（BMI）、患侧、既往史（吸烟、饮酒史）、糖尿病、高血压、手术时间、总胆固醇、三酰甘油、纤维蛋白原、血红蛋白、白蛋白、血小板、D-二聚体、国际标准化比值（INR）、纤维蛋白降解产物。对这些因素进行单因素分析，有统计学意义的因素进一步采用二元 Logistic 回归模型进行分析，评估其与全髋关节置换术后 DVT 的相关性。
共纳入 462 例患者，DVT 组占比约 14%，非 DVT 组占比约 86%。DVT 组患者的平均年龄为 67.27±4.10 岁，非 DVT 组患者的平均年龄为 66.72±8.69 岁。单因素分析显示，糖尿病、术前纤维蛋白原、术前 D-二聚体、术前 INR 以及术前和术后纤维蛋白降解产物在 DVT 组和非 DVT 组间差异有统计学意义。二元 Logistic 回归分析显示，糖尿病、术前纤维蛋白原升高、术前 D-二聚体升高和术前 INR（p<0.05）是全髋关节置换术后 DVT 的危险因素。
本研究发现糖尿病、术前纤维蛋白原升高、术前 D-二聚体升高和术前 INR 是全髋关节置换术后 DVT 的独立危险因素。外科医生应全面评估这些危险因素，及时采取有效干预措施，并指导患者尽早进行功能锻炼，以降低 DVT 的发生率，从而改善全髋关节置换术的预后，提高患者的生活质量。
