| 初次髋膝关节置换术后静脉血栓发生情况的观察比较 |
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投稿时间：2016-03-20
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| 作者 | Author | 单位 | Address | E-Mail |
| 谢锦伟 |
XIE Jin-wei |
四川大学华西医院骨科, 四川 成都 610041 |
Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China |
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| 岳辰 |
YUE Chen |
四川大学华西医院骨科, 四川 成都 610041 |
Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China |
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| 马俊 |
MA Jun |
四川大学华西医院骨科, 四川 成都 610041 |
Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China |
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| 沈彬 |
SHEN Bin |
四川大学华西医院骨科, 四川 成都 610041 |
Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China |
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| 杨静 |
YANG Jing |
四川大学华西医院骨科, 四川 成都 610041 |
Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China |
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| 周宗科 |
ZHOU Zong-ke |
四川大学华西医院骨科, 四川 成都 610041 |
Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China |
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| 康鹏德 |
KANG Peng-de |
四川大学华西医院骨科, 四川 成都 610041 |
Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China |
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| 裴福兴 |
PEI Fu-xing |
四川大学华西医院骨科, 四川 成都 610041 |
Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China |
peifuxing@vip.163.com |
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| 期刊信息：《中国骨伤》2016年，第29卷，第8期，第708-712页 |
| DOI：10.3969/j.issn.1003-0034.2016.08.007 |
| 基金项目:国家卫生计生委卫生行业科研专项基金（编号：201302007） |
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| 中文摘要:目的：通过对大样本的初次全髋、膝关节置换术患者的资料进行统计分析，描述初次髋、膝关节术后静脉血栓的发生率及解剖分布。方法：纳入2013年12月至2014年12月行初次全髋、膝关节置换术1 686例患者，其中THA 928例，TKA 758例。所有患者术前、出院前常规行双下肢静脉彩超，术中常规使用抗纤溶药，术后抗凝14 d.统计分析术后血栓发生类型及其解剖分布。结果：初次全髋关节置换术患者928例，30例出现血栓，27例为孤立性肌间静脉血栓，其次为累及腓静脉或胫后静脉的周围性血栓，无中心型血栓发生。初次全膝关节置换术患者 758例中，87例出现血栓，81例为周围型血栓，4例为中心型血栓，其余2例为混合型血栓；74例的血栓累及单支静脉，65例累及肌间静脉、4例股静脉、3例胫后静脉、2例浅静脉；13例的血栓累及多支静脉，多累及肌间静脉、胫后静脉、腓静脉、腘静脉中的2支或3支。对比结果发现，全膝关节置换术后血栓发生率较高，差异有统计学意义（P<0.001），且更容易出现中心型血栓及多支静脉受累。结论：在现代血栓预防措施的干预下，初次髋、膝关节置换术后血栓发生率较低，其发生率及解剖分布存在差异。 |
| 【关键词】关节成形术,置换,髋 关节成形术,置换,膝 静脉血栓栓塞 |
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| Incidence and anatomic distribution of venous thromboembolism following primary total hip and knee arthroplasty:a prospective observational study |
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| ABSTRACT Objective: 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. Methods: 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. Results: 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(P<0.001),and more prone to central thrombosis and multiple venous involvement. Conclusion: 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. |
| KEY WORDS Arthroplasty,replacement,hip Arthroplasty,replacement,knee Venous thromboembolism |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 谢锦伟,岳辰,马俊,沈彬,杨静,周宗科,康鹏德,裴福兴.初次髋膝关节置换术后静脉血栓发生情况的观察比较[J].中国骨伤,2016,29(8):708~712 |
| 英文格式: | XIE Jin-wei,YUE Chen,MA Jun,SHEN Bin,YANG Jing,ZHOU Zong-ke,KANG Peng-de,PEI Fu-xing.Incidence and anatomic distribution of venous thromboembolism following primary total hip and knee arthroplasty:a prospective observational study[J].zhongguo gu shang / China J Orthop Trauma ,2016,29(8):708~712 |
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