摘要
目的了解人工全膝关节置换术(total knee arthroplasty,TKA)后症状性下肢深静脉血栓(deep vein thrombosis,DVT)患者的临床特点及高危因素。方法回顾性研究2015-07至2020-06北京积水潭医院收治的8162例TKA患者临床资料,记录术后出现症状性DVT及继发的肺动脉血栓栓塞症(pulmonary thromboembolism,PTE)情况,分析患者年龄、身体质量指数、手术时间、高血压病史、糖尿病病史、术前D二聚体、术前三酰甘油、术前胆固醇及术前血尿酸与症状性DVT发生风险的相关性。结果TKA术后有65例症状性DVT患者(0.80%),中位发生时间为术后第3天,远端DVT占比(73.85%)明显高于近端DVT(26.15%);继发症状性PTE有5例,仅1例为高危分层。术前血尿酸增高是症状性DVT的危险因素(OR=2.532;95%CI=1.207~5.310;P=0.014)。结论TKA患者尽管给予常规预防,但仍无法避免术后症状性DVT的发生,对于术前血尿酸增高的患者在围术期预防中需给予更多关注。
Objective To investigate the clinic features and risk factors for symptomatic deep vein thrombosis(DVT)patients after total knee arthroplasty(TKA).Methods A total of 8162 patients undergoing TKA were included in this study.Cases of symptomatic DVT and pulmonary thromboembolism(PTE)were recorded.The association of age,body mass index(BMI),duration of surgery,a history of hypertension and diabetes,and preoperative serum levels of uric acid,cholesterol,triglyceride and D-dimer with symptomatic DVT was analyzed.Results Sixty-five patients(0.80%)presented with symptomatic DVT,which occurred within median 3 days postoperatively.These cases included 48 cases of distal DVT(73.85%)and 17 cases of proximal DVT(26.15%).There were 5 cases of pulmonary thromboembolism(PTE)after TKA,only one of whom was at high risk.The preoperative serum levels of uric acid in symptomatic DVT patients were significantly higher than those of other patients,indicating correlations(OR=2.532;95%CI=1.207-5.310;P=0.014)between the preoperative serum levels of uric acid and symptomatic DVT.Conclusions Postoperative DVT can hardly be prevented despite conventional precautions.An increased preoperative serum level of uric acid is a risk factor for symptomatic DVT after TKA.Therefore,effective preventive measures are needed for these patients.
作者
刘晓阳
尹星华
戴丽
程洋
LIU Xiaoyang;YIN Xinghua;DAI Li;CHENG Yang(Department of Respiratory and Critical Care Medicine,Beijing Jishuitan Hospital,Beijing 100035,China;De⁃partment of Orthopeadics,Beijing Jishuitan Hospital,Beijing 100035,China)
出处
《武警医学》
CAS
2022年第3期222-225,共4页
Medical Journal of the Chinese People's Armed Police Force
