膝髋关节置换术后周围型血栓的解剖分布

发布时间：2018-08-13 18:44

【摘要】：目的：探讨全膝关节置换和全髋关节置换术后周围型血栓的解剖分布以及评估影响小腿血栓分布的因素。方法：2007年6月至2012年5月,共有172名患者接受初次全膝关节置换术或全髋关节置换术后并在术后7天内经下肢静脉造影诊断为周围型血栓。记录所有血栓累及的部位并将血栓分为组A(血栓仅累及一个部位或者一条静脉)和组B(血栓累及两条或者两条静脉以上)。比较两组间的血栓分布,并评估影响血栓的因素。结果：在组A共122名患者中,肌间静脉是最易累及的部位(70.5%),其次为胫后静脉(18.9%),腓静脉(7.6%)。组B(50例)中,腓静脉和胫后静脉同时累及共11例,占(22%)；胫后静脉、腓静脉和肌间静脉三者累及8例(16%)。手术类型影响小腿血栓的分布(p=0.013)。在多元逻辑回归分析中,全膝关节置换的病人累及多条静脉血栓的概率是全髋关节置换术后的2.326倍(p=0.026,95%CI=0.204-0.904)。结论：膝髋关节置换术后周围型血栓中,最常见的部位是肌间静脉。相比于全髋关节置换术,全膝关节置换术后急性期内形成的小腿静脉血栓更容易累及两条或者两条以上的静脉。
[Abstract]:Objective: To investigate the anatomical distribution of peripheral thrombus after total knee arthroplasty (TKA) and total hip arthroplasty (THA) and to assess the factors affecting the distribution of thrombus in the lower leg. Methods: From June 2007 to May 2012, 172 patients underwent primary total knee arthroplasty (TKA) or total hip arthroplasty (THA) and were diagnosed by lower extremity venography within 7 days after surgery. Peripheral thrombosis. All thrombus sites were recorded and divided into group A (thrombus involving only one site or vein) and group B (thrombus involving two or more veins). The distribution of thrombus between the two groups was compared and the factors affecting thrombosis were evaluated. Results: Intermuscular veins were the most easily involved in group A of 122 patients. In group B (50 cases), 11 cases (22%) were involved in both the peroneal vein and the posterior tibial vein, 8 cases (16%) were involved in the posterior tibial vein, the peroneal vein and the intermuscular vein. The risk of multiple venous thrombosis was 2.326 times higher (p = 0.026, 95% CI = 0.204-0.904) after total hip arthroplasty. Conclusion: The most common site of peripheral thrombosis after total hip arthroplasty is the intermuscular vein. Or more than two veins.
【学位授予单位】：南京大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R687.4;R322.7

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