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中华关节外科杂志(电子版)

中华关节外科杂志(电子版) ›› 2023, Vol. 17 ›› Issue (04) : 588 -591. doi: 10.3877/cma.j.issn.1674-134X.2023.04.020

临床经验

住院天数影响全膝关节置换术后下肢深静脉血栓形成
邵长杰, 杜晓颖, 徐奎帅, 张靓, 纪岩磊†()   
  1. 250117　济南，山东省肿瘤防治研究院（山东省肿瘤医院），山东第一医科大学（山东省医学科学院）特检科
    266000　青岛大学附属医院骨科
  • 收稿日期:2022-02-08 出版日期:2023-08-01
  • 通信作者: 纪岩磊

Length of hospital stay and deep venous thrombosis in lower limbs after total knee arthroplasty

Changjie Shao, Xiaoying Du, Kuishuai Xu, Liang Zhang, Yanlei Ji†()   

  1. Department of Special Diagnosis, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250117, China
    Department of Orthopedic, Affiliated Hospital of Qingdao University, Qingdao 266000, China
  • Received:2022-02-08 Published:2023-08-01
  • Corresponding author: Yanlei Ji
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邵长杰, 杜晓颖, 徐奎帅, 张靓, 纪岩磊. 住院天数影响全膝关节置换术后下肢深静脉血栓形成[J]. 中华关节外科杂志(电子版), 2023, 17(04): 588-591.

Changjie Shao, Xiaoying Du, Kuishuai Xu, Liang Zhang, Yanlei Ji. Length of hospital stay and deep venous thrombosis in lower limbs after total knee arthroplasty[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2023, 17(04): 588-591.

目的

评估住院天数对全膝关节置换术(TKA)后下肢深静脉血栓(DVT)形成的影响。

方法

回顾性分析2011年至2021年于青岛大学附属医院行初次单侧TKA术的7 179名患者的临床资料。根据患者出院后是否发生血栓将患者分为DVT组和无DVT组，绘制不同住院天数的患者出院后发生DVT比例的折线图。两组患者的一般临床资料比较采用t检验和卡方检验。

结果

患者平均年龄(65.9±7.6)岁，其中男性2 568例，女性4 611例。出院后DVT的发生率为0.9%(64/7 179)；以小腿肌间静脉受累为主，发生率87.5%(56/64)。随着住院天数的增加，TKA术后的患者出院后DVT的发生率也呈递增趋势。

结论

住院天数越长，TKA术后的患者出院后发生DVT的风险越高。

关键词: 关节成形术，置换，膝, 静脉血栓形成
Objective

To evaluate the effect of length of stay on deep venous thrombosis (DVT) after total knee arthroplasty (TKA).

Methods

The clinical data of 7 179 patients undergoing primary unilateral TKA in Affiliated Hospital of Qingdao University from 2011 to 2021 were retrospectively analyzed. The patients were divided into DVT group and non-DVT group according to whether thrombosis occurred after discharge. The general clinical data of the two groups were analyzed by t test or chi square test. The broken-line diagram of DVT proportion of patients with different length of stay after discharge was drawn.

Results

The average age of the patients was (65.9±7.6) years, including 2 568 males and 4 611 females. The incidence of DVT after discharge was 0.9% (64/7179), mainly involving the intermuscular vein which was 87.5% (56/64). The results of the broken line diagram showed that with the increase of length of hospital stay, the incidence of DVT in patients after TKA was also increasing.

Conclusion

The longer the length of hospital stay, the higher the risk of DVT after TKA.

Key words: Arthroplasty, replacement, knee, Venous thrombosis
表1 DVT组与无-DVT组患者基线资料比较
Table 1 Comparison of baseline data between DVT group and non-DVT group
参数Factors DVT组DVT group 无DVT组Non-DVT group 统计值 P值
例数Case number 64 7115    
年龄[岁，(±s)] Age 67±8 66±8 t＝1.471 >0.05
性别(例)Gender     χ2＝1.157 >0.05
男male 27 2 541    
女female 37 4 574    
BMI(kg/m2)     χ2＝2.247 >0.05
18.5~22.9 8 824    
23.0~24.9 8 1 210    
25.0~29.9 38 3 650    
≥30 10 1 431    
患肢侧别(例)Involved side     χ2＝0.734 >0.05
左侧left 28 3 494    
右侧right 36 3 618    
合并疾病数(例)Complication types     χ2＝3.061 >0.05
0 21 2 257    
1 16 2 460    
≥2 27 2 398    
手术时间[min，(±s)] Operation duration 85±23 84±26 t ＝－0.289 >0.05
住院天数[d，(±s)] Length of hospital stay 12±5 9±4 t＝－5.215 <0.001
图1 不同住院天数的患者出院后发生下肢DVT(深静脉血栓)的比例
Figure 1 Proportion of DVT in patients with different length of stay after discharge
图2 下肢深静脉血栓声像图。图A为左侧股浅静脉血栓二维声像图；图B为左侧股浅静脉血栓彩色多普勒成像；图C为右侧小腿肌间静脉血栓二维声像图；图D为右侧小腿肌间静脉血栓彩色多普勒成像
Figure 2 Ultrasonography of deep venous thrombosis of lower limbs. A is two-dimensional ultrasonography of left superficial femoral vein thrombosis femoral vein thrombosis；B is color doppler imaging of left superficial femoral vein thrombosis；C is two-dimensional ultrasonography of right calf muscular venous thrombosis；D is color doppler imaging of right calf muscular venous thrombosis
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