切换至 "中华医学电子期刊资源库"

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
引用本文:

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/OL]. 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/OL]. 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。

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.

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
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
[1]
Michael JWP, Schlüter-Brust KU, Eysel P. The epidemiology, etiology, diagnosis, and treatment of osteoarthritis of the knee[J]. Dtsch Arztebl Int, 2010, 107(9): 152-162.
[2]
Canovas F, Dagneaux L. Quality of life after total knee arthroplasty[J]. Orthop Traumatol Surg Res, 2018, 104(1S): S41-S46.
[3]
曾敬,赵洪普,杨展翔,等. 全膝关节置换术后静脉血栓栓塞症危险因素的Meta分析[J/CD]. 中华关节外科杂志(电子版), 2019, 13(1): 78-85.
[4]
Bosque J Jr, Coleman SI, di Cesare P. Relationship between deep vein thrombosis and pulmonary embolism following THA and TKA[J]. Orthopedics, 2012, 35(3): 228-233;quiz 234-235.
[5]
Salomon B, Dasa V, Krause PC, et al. Hospital length of stay is associated with increased likelihood for venous thromboembolism after total joint arthroplasty[J]. Arthroplast Today, 2021, 8: 254-257.e1.
[6]
Lung BE, Kanjiya S, Bisogno M, et al. Risk factors for venous thromboembolism in total shoulder arthroplasty[J]. JSES Open Access, 2019, 3(3): 183-188.
[7]
Liu J, Wilson L, Poeran J, et al. Trends in total knee and hip arthroplasty recipients: a retrospective cohort study[J]. Reg Anesth Pain Med, 2019, 44(9): 854-859.
[8]
Nadi, Vreugdenburg TD, Atukorale Y, et al. Safety and effectiveness of aspirin and enoxaparin for venous thromboembolism prophylaxis after total hip and knee arthroplasty: a systematic review[J]. ANZ J Surg, 2019, 89(10): 1204-1210.
[9]
Sloan M, Sheth N, Lee GC. Is obesity associated with increased risk of deep vein thrombosis or pulmonary embolism after hip and knee arthroplasty? A large database study[J]. Clin Orthop Relat Res, 2019, 477(3): 523-532.
[10]
Xu H, Zhang S, Xie J, et al. A nested case-control study on the risk factors of deep vein thrombosis for Chinese after total joint arthroplasty[J/OL]. J Orthop Surg Res, 2019, 14(1): 188. DOI: 10.1186/s13018-019-1231-9.
[11]
Tay K, Bin Abd Razak HR, Tan AH. Obesity and venous thromboembolism in total knee arthroplasty patients in an Asian population[J]. J Arthroplasty, 2016, 31(12): 2880-2883.
[12]
扈鑫,高石军,董江涛,等. 中老年全膝关节置换术后下肢深静脉血栓形成的解剖部位分布特点[J/CD]. 中华老年骨科与康复电子杂志2017, 3(5): 296-301.
[13]
Barrellier MT, Bosson JL, Vignon C, et al. Echo-Doppler for early diagnosis of deep venous thrombosis in orthopedic surgery and traumatology. A retrospective study of 1, 647 patients[J]. J Mal Vasc, 1994, 19(4): 298-307.
[1] 曹琨芃, 王昕玥, 吴柳希, 邓红艳, 李璐, 徐超丽, 叶新华. 淋巴瘤患者超声引导下颈内静脉置管术后静脉血栓形成的危险因素评估[J/OL]. 中华医学超声杂志(电子版), 2024, 21(03): 310-318.
[2] 丁莹莹, 宋恺, 金姬延, 田华. 机器人辅助膝髋关节置换术后精细化临床护理[J/OL]. 中华关节外科杂志(电子版), 2024, 18(04): 553-557.
[3] 任俊筱, 浦路桥, 王志豪, 施洪鑫, 刘爱峰, 齐保闯, 徐永清, 李川. 机器人辅助全膝关节置换术的临床疗效对照研究[J/OL]. 中华关节外科杂志(电子版), 2024, 18(04): 469-476.
[4] 许亚龙, 巩栋, 陈晓涛. 超前镇痛在全膝关节置换术中的研究进展[J/OL]. 中华关节外科杂志(电子版), 2024, 18(04): 517-523.
[5] 王冰, 孙海宁, 于秀淳, 周珂, 翟凯, 苗族康. 膝骨关节炎的活动衬垫型单髁置换疗效与假体生存率[J/OL]. 中华关节外科杂志(电子版), 2024, 18(03): 337-345.
[6] 张江礼, 刘金辉, 潘西庆, 刘光源, 范虓. 全膝关节置换应用智能辅助手术导航系统治疗膝骨关节炎[J/OL]. 中华关节外科杂志(电子版), 2024, 18(03): 346-351.
[7] 杨士慷, 曹光磊. 膝骨关节炎三种术式患者满意度的术前影响因素[J/OL]. 中华关节外科杂志(电子版), 2024, 18(03): 390-397.
[8] 王啸, 李一凡, 沈素红, 曹国瑞, 史小涛, 袁彦浩, 谭红略. 全膝关节置换术后早期下肢深静脉血栓形成的时空规律[J/OL]. 中华关节外科杂志(电子版), 2024, 18(03): 414-420.
[9] 刘浩, 郑清源, 程龙, 辛鹏, 吴博, 任鹏, 张国强. 全膝关节置换术中选择窄版股骨假体的影响因素[J/OL]. 中华关节外科杂志(电子版), 2024, 18(02): 193-200.
[10] 卢芳连, 汤莉, 何河北, 李建云, 欧栓机, 陈燕, 陈娇妹. 责任护士主导的疼痛管理在膝关节置换术后的应用[J/OL]. 中华关节外科杂志(电子版), 2024, 18(02): 285-289.
[11] 赵锦伟, 李晓军, 刘桂宇, 荣晓玲, 黄明利, 宋文静, 高广凌, 鞠昌军. 固定平台假体膝关节单髁置换术中止血带应用策略研究[J/OL]. 中华关节外科杂志(电子版), 2024, 18(01): 39-47.
[12] 姚金含, 王伟娜, 张玉泉. 妊娠相关深静脉血栓形成患者的预后研究现状[J/OL]. 中华妇幼临床医学杂志(电子版), 2024, 20(04): 367-373.
[13] 黄应雄, 叶子, 蒋鹏, 詹红, 姚陈, 崔冀. 急性肠系膜静脉血栓形成致透壁性肠坏死的临床危险因素分析[J/OL]. 中华普通外科学文献(电子版), 2023, 17(06): 413-421.
[14] 王勇, 王丽. 导管接触性溶栓治疗下肢深静脉血栓安全性和有效性的系统评价再评价[J/OL]. 中华介入放射学电子杂志, 2024, 12(01): 58-63.
[15] 葛静萍, 尹媛媛, 李燕. 梯度压力袜联合间歇充气加压在老年新型冠状病毒肺炎患者预防下肢深静脉血栓形成中的应用[J/OL]. 中华介入放射学电子杂志, 2024, 12(01): 70-74.
阅读次数
全文


摘要