| 应璞,许岳,蒋晓伟,等.创伤性股骨头坏死病人术前临床病史与全髋关节置换术后深静脉血栓的相关性分析[J].安徽医药,2025,29(1):137-141. |
| 创伤性股骨头坏死病人术前临床病史与全髋关节置换术后深静脉血栓的相关性分析 |
| Association between preoperative clinical history and deep venous thrombosis after hip arthroplasty in patients with traumatic femoral head necrosis |
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| DOI：10.3969/j.issn.1009-6469.2025.01.028 |
| 中文关键词: 股骨头坏死 全髋关节置换术 深静脉血栓 临床病史 冠心病 |
| 英文关键词: Femur head necrosis Total hip arthroplasty Deep venous thrombosis Clinical history Coronary heart disease |
| 基金项目:苏州市科技发展计划指导性项目( SKJYD2021007，SKJYD2021202)；苏州市“科教兴卫”青年科技项目( KJXW2020068)；常熟市卫健委科技计划项目资助性重点项目( CSWS202118)；南京中医药大学常熟附属医院课题( cszyy201910) |
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| 中文摘要: |
| 目的研究创伤性股骨头坏死( FHN)病人术前临床病史与全髋关节置换术( THA)后深静脉血栓的相关性。方法回顾性分析 2014年 8月至 2022年 5月共 172例因创伤性 FHN来南京中医药大学常熟附属医院行单侧 THA术的病人临床资料。所有病人均在 THA术后行常规低分子肝素( LWMH)抗凝，并于术后第 3天行双下肢静脉 B超检查。按检查结果将病人分成 DVT组(男 22例，女 4例，平均年龄 64.35岁)和非 DVT组(男 102例，女 44例，平均年龄 62.35岁)。分别比较两组病人术前基本临床病史如既往 VTE病史、糖尿病、高血压、冠心病( CHD)等与 DVT的具体相关性并通过多变量分析 DVT发生的危险因素。结果 DVT组中 CHD发病率为 73.08%(19/26)，显著高于非 DVT组的 31.51%(46/146)。创伤性 FHN病人合并 CHD［OR=6.63， 95%CI:(1.49，29.59)P=0.013］或长期吸烟史［ OR=4.58，95%CI:(1.26，16.62)P=0.021］是 THA术后 DVT的发生危险因素。结论冠心病和吸烟史是，创伤性 FHN病人行单侧 THA术后 DVT发生的危险因素，对，于此类病人需重视术前疾病控制，同时应规范手术操作以减少术后 DVT的发生。 |
| 英文摘要: |
| Objective To investigate the association of preoperative clinical history and deep venous thrombosis after total hip arthro-plasty (THA) in patients with traumatic femoral head necrosis (FHN).Methods The clinical data of 172 patients who received unilat-eral THA in Changshu Hospital Affiliated to Nanjing University of Chinese Medicine due to traumatic FHN from August 2014 to May2022 were retrospectively analyzed. All patients received routine anticoagulation with low molecular weight heparin (LWMH) afterTHA and ultrasound examination of both lower extremity veins was performed on the third day postoperatively. According to examina-tion results patients were divided into the DVT (22 males 4 females an average age of 64.35 years) and the non-DVT group (102 males44 females an average age of 62.35 years). The specific association between preoperative basic clinical history of patients such as previ-ous history of VTE diabetes hypertension coronary heart disease (CHD) and DVT was compared and the risk factors of DVT were ana-lyzed by multivariate analysis.Results The incidence of CHD in DVT group was 73.08% (19/26), which was significantly higher than 31.51% (46/146) in non-DVT group. Traumatic FHN patients with CHD [OR=6.63,95%CI:(1.49,29.59), P=0.013] or long-term smoking history[OR=4.58,95%CI:(1.26,16.62), P=0.021] were risk factors for DVT after THA.Conclusions Coronary heart disease and smok-ing history are risk factors for DVT after unilateral THA in patients with traumatic FHN. For such patients, preoperative disease controlshould be emphasized, and surgical procedures should be standardized to reduce the occurrence of postoperative DVT. |
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