全髋关节置换术后深静脉血栓栓塞症的发生与改良APACHEⅡ评分相关性研究Study on correlation of improved APACHEⅡ scoring systems and deep venous thromboembolism after total hip replacement
赵金柱;曲良;宋展昭;
摘要(Abstract):
[目的]探讨全髋关节置换术后深静脉血栓栓塞症(DVT)的发生与改良APACHEⅡ评分的相关性。[方法]选择2009年1月~2010年1月解放军401医院骨科接受初次人工全髋关节置换术的患者50例(52髋),对入选患者定期(术后24 h、术后3 d及术后10 d)及临床出现可疑DVT症状时随时进行双下肢静脉彩色多普勒超声检查,将患者按照多普勒超声检查结果分为DVT组(A组)及无DVT组(B组)。同时对两组患者进行改良APACHEⅡ评分,记录各组的改良APACHEⅡ评分,并对两组数据进行统计学分析。[结果]50例患者中19例术后超声检查发现下肢DVT,其中近端血栓12例,远端血栓7例,发生肢体均为术侧,术后DVT发生率为38%;DVT组(A组)改良APACHEⅡ评分为(18.11±3.87)分,无DVT组(B组)APACHEⅡ评分为(13.39±4.29)分,两组改良A-PACHEⅡ评分比较有统计学意义(P<0.05)。[结论]改良APACHEⅡ评分与全髋关节置换后早期DVT的发生有相关性,改良APACHEⅡ评分为全髋关节置换术后DVT的预测提供了新思路。
关键词(KeyWords): APACHEⅡ评分;改良;全髋关节置换术;深静脉血栓栓塞症;相关性
基金项目(Foundation):
作者(Author): 赵金柱;曲良;宋展昭;
Email:
DOI:
参考文献(References):
- [1]裴婓.新型抗凝治疗药物-利伐沙班[J].中国药物应用与监测,2010,4:260.
- [2]Wells PS,Hirsh J,Anderson DR,et al.Accuracy of clinical assesmentof deep-vein thrombosis[J].Lancet,1995,8961:1326-1304.
- [3]Oudega R,Hoes AW,Moons KG.The Wells rule does not adequatelyrule out deep venous thrombosis in primary care patients[J].Ann In-tern Med,2005,2:100-107.
- [4]Stevens SM,Ageno W.The Wells rule was not useful in ruling out deep ve-nous thrombosis in primary care setting[J].Evid Based Med,2006,2:57.
- [5]赵金柱,宋展昭,胡健,等.全髋关节置换后深静脉血栓栓塞与A-PACHEⅡ评分:98例资料回顾[J].中国组织工程研究与临床康复,2010,22:4050-4052.
- [6]Ebell MH.Evaluation of the patient with suspected deep vein thrombo-sis[J].Fam Pract,2001,1:16-17.
- [7]吕厚山,徐斌.人工关节置换术后下肢深静脉血栓形成[J].中华骨科杂志,1999,3:155-160.
- [8]王琦,张先龙,沈俊,等.“低风险”人群初次人工关节置换术后的深静脉血栓[J].中华骨科杂志,2007,2:106-109.
- [9]曲洪雪,刘云鹏.骨科深静脉血栓形成危险因素及发病机制的研究进展[J].中国矫形外科杂志,2009,2:110-112.
- [10]Ridker PM,Miletich JP,Stampfer MJ,et al.Factor V leiden and risk ofrecurrent idiopathic venous thromboembolism[J].Circulation,1995,10:2800-2802.
- [11]Knaus WA,Draper EA,Wagner DP,et al.APACHE2:a severity of dis-ease classificalion system[J].Cril Care Med,1985,10:818-829.
- [12]Shrroch NE,Go G,Williams-Russo P,et al.Comparison of extraduraland genral anaesthesia on the fibrinolytic response to total knee arthro-plasty[J].Br J Anaesth,1997,1:29-34.
- [13]沈彬,杨静,裴福兴.骨水泥型全髋关节置换术中的严重并发症及其防治措施[J].四川医学,2006,6:615-617.
- [14]马俊,沈彬,杨静,等.人工全髋关节置换术后下肢深静脉形成的危险因素分析[J].中国矫形外科杂志,2009,13:965-969.
- [15]康淑芳,喻荔琳,陈荔华.外科术后患者深静脉血栓形成的预防及护理[J].中国医学理论与实践,2002,8:1085.