高龄老人髋关节置换的高危因素128例特征.docVIP

高龄老人髋关节置换的高危因素：128例特征 张克云1，余黎明1，张绪华1，林? 昕1，张仁明1，刘? 俊1，陈? 超2，王建超2 1湖南怀化医专附属医院暨怀化市第三人民医院骨科，湖南省怀化市? 418000；2华中科技大学同济医学院同济医院骨科，湖北省武汉市? 430032 High risk factors in 128 elderly patients undergoing hip replacement Zhang Ke-yun1, Yu Li-ming1, Zhang Xu-hua1, Lin Xin1, Zhang Ren-ming1, Liu Jun1, Chen Chao2, Wang Jian-chao2 1?Department of Orthopedics, Affiliated Hospital of Huaihua Medical College, i.e., Huaihua Municipal Third People’s Hospital, Huaihua 418000, Hunan Province, China;?2?Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430032, Hubei Province, China 背景：髋关节置换后的临床并发症深静脉血栓具有较高的发生率，并且深静脉血栓能够导致危及患者生命安全的肺栓塞以及远端深静脉的功能障碍，因此深静脉血栓出现对于逐渐增多的髋关节置换是一个极大的障碍。目的：观察老年患者全髋关节置换后下肢深静脉血栓的发生情况，筛选下肢出现深静脉血栓的危险因素。方法：对128例髋关节置换老年患者临床资料进行回顾性分析，全部患者在置换前1 d及置换后的第7天分别进行双下肢的彩超检查，将患者下肢是否发生深静脉血栓与临床的可疑因素予以Logistic非条件多因素分析。结果与结论：在置换后的第7天出现下肢深静脉血栓患者共16例，其中女性、全身麻醉、双侧髋关节置换、骨水泥的应用为下肢深静脉血栓出现的显著因素，其P值 0.05，能够导致70岁以上老年患者在实施全髋关节置换后出现深静脉血栓的风险呈显著性增加。Logistic非条件多因素的分析中显示性别、肥胖、骨水泥的使用3个因素在老年患者中深静脉血栓出现的风险倍数依次增加达11.398，3.109，8.925；患者血型为O型的70岁以上老年患者在实施全髋关节置换后出现深静脉血栓的风险则显著降低，在置换后出现深静脉血栓降低至0.186倍，能够被作为出现深静脉血栓的一项保护性因素。 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 全文链接： 关键词?：?植入物；?人工假体；?髋关节置换；?深静脉血栓；?危险因素；?发生率；?老年人； Abstract： BACKGROUND:?Deep vein thrombosis after hip replacement has a high incidence rate. Moreover, deep vein thrombosis can induce pulmonary embolism that can endanger patients’ life and dysfunction of distant deep vein. The appearance of deep vein thrombosis is a great obstacle for the gradually increased hip replacement.?OBJECTIVE:?To observe the occurrence of deep vein thrombosis of lower limb after total hip replacement in elderly patients, and to screen the risk factors for the occurrence of deep vein thrombosis of lower limbs.?METHODS:?Clinical data of 128 elderly patients with hip replacement were analyzed retrospectively. All patients were examined with color Doppler ultrasound in double lower limbs at 1