利用Caprini血栓风险模型分析股骨头缺血坏死(ANFH)患者行髋关节置换术(THA)后发生深静脉血栓(DVT)的情况。

回顾近几年来在赤峰市医院行THA治疗的ANFH患者。纳入条件：Ficat Ⅳ期ANFH，首次行THA术，单侧THA术，术后采用低分子肝素及物理措施预防DVT；排除条件：术前经超声检查发现已存在下肢DVT，采用骨水泥型假体。根据THA术后35 d内是否出现了下肢DVT，分为DVT组、非DVT组。采用Mann-Whitney U秩和检验比较两组患者的Caprini血栓风险模型评分。

共纳入研究对象93例，其中DVT组9例(9.68%)、非DVT组84例(90.32%)。两组患者的年龄(t＝-1.198)、性别(Fisher’s精确概率法P>0.05)、手术时长(t＝-1.391)、术中出血量(Z＝-1.745)较接近，差异无统计学意义(P>0.05)。DVT组患者在单项分值为3分的危险因素组(Z＝-3.183)、及Caprini总分(Z＝-2.242)方面的评分更高，差异具有统计学意义(P<0.05)。

对于行THA治疗的ANFH患者，应积极关注Caprini血栓风险模型中评分为3分的危险因素，如：静脉血栓栓塞性疾病病史或血栓家族史，以便及早发现并处理DVT。

To use the Caprini risk assessment model to analyze the occurrence of deep vein thrombosis (DVT) in patients with avascular necrosis of the femoral head (ANFH) after total hip arthroplasty (THA).

The ANFH patients who have been treated with THA in Chifeng Municipal hospital in recent years were reviewed. Inclusion creteria: Ficat Ⅳ ANFH, THA surgery for the first time, unilateral THA surgery, postoperative use of low molecular weight heparin and physical measures to prevent DVT. Exclusion cretieria: preoperative ultrasound examination found that DVT of the lower extremities existed, cement prosthesis was used. According to whether lower limb DVT occurred within 35 days after THA, they were divided into DVT group and non-DVT group. Mann-Whitney U test was used to compare the Caprini risk assessment model scores of the two groups of patients.

A total of 93 study subjects were included, including nine cases (9.68%) in the DVT group and 84 cases (90.32%) in the non-DVT group. The age (t=-1.198), gender (Fisher's exact test P>0.05), operation time (t=-1.391), intraoperative blood loss (Z=-1.745) of the two groups of patients were similar, and the difference was not statistically significant (P>0.05). The patients in the DVT group scored higher in the risk factors with a single score of three(Z=-3.183, P<0.05) and in the total Caprini score, and the differences were statistically significant (Z=-2.242, P<0.05).

For ANFH patients undergoing THA therapy, the risk factors scored as three points in the Caprini risk assessment model, such as the history of venous thromboembolic disease or the family history of thrombosis, should be paid attention to in order to detect and treat DVT as soon as possible.