胸腰椎骨折内固定术后深静脉血栓形成Deep Venous Thrombosis after Thoracolumbar Fracture Internal Fixation
周许辉,谭军,贾连顺,陈雄生,周志林
摘要(Abstract)：
目的 :探讨胸腰椎骨折内固定术后深静脉血栓的发生情况及预防措施。方法 :6 5例胸腰椎骨折内固定术患者 ,2 9例术后用弹力袜 ,36例口服法华林预防深静脉血栓形成。术后第 6d行双下肢彩色多谱勒超声扫描 ,分析深静脉血栓的发生情况及两种措施的作用效果。结果 :共有 3例发生深静脉血栓 ,均来自弹力袜组 ,1例为前路手术 ,2例为后路手术。结论 :小剂量口服法华林预防深静脉血栓形成的效果优于弹力袜 (P <0 .0 5 )。深静脉血栓形成与患者年龄、体重、手术入路、手术时间、吸烟史无显著相关性
关键词(KeyWords)： 胸腰椎内固定;深静脉血栓;手术后并发症
基金项目(Foundation):
作者(Author): 周许辉,谭军,贾连顺,陈雄生,周志林
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参考文献(References)：
- 〔1〕 RolitoSE ,SchwartzMC ,NeuwirthMG .Deepveinthrom bosisaftermojorreconstructionspinalsurgery[J] .Spine ,1996 ,2 1:85 3～ 85 9.
- 〔2〕 Denis .Spinalinstabilityasdefinedbythethreecolumnspineconceptinacutespinaltrumatism [J] .Orthop ,1984,198:6 5 .
- 〔3〕 SunX ,EvattB ,GriffinJH .BloodcoagulationfactorVaab normalityassociatedwithresistancetoactivatedproteinCinvenousthrombophilia[J] .Blood ,1994,83 :312 0～ 312 5 .
- 〔4〕 JohnT ,DearB .Thromboemboliccomplicationsaftermajorthoracolumbarspinesurgery[J] .Spine ,1999,2 4:14 71～14 76 .
- 〔5〕 StulbergBN ,IncallJN ,WilliamsGW ,etal.Deep veinthrombosisfollowingtotalkneereplacement ;ananalysisofsixhundredandthirty eigharthroplasties[J] .JBoneJointSurg(Am ) ,1984,6 6 :194～ 2 0 1.
- 〔6〕 HaakeDA ,BerkmanSA .Venousthromboembolicdiseaseafterhipsurgery ;riskfactors ,prophylaxis ,anddiagnosis[J] .ClinOrthop ,1989,2 42 :2 12～ 2 31.
- 〔7〕 WattJM .B modeultrasoundscanninginthedetectionofproximalvenousthrombosisaftertotalhipreplacement[J] .JBoneJointSurg(Am ) ,1990 ,72 :983～ 987.
- 〔8〕 SmithMD ,BresslerEC ,LonsteinJE .Deepvenousthrom bosisandpulmonaryembolishaftermajorreconstructiveop erationsonthespine[J] .JBoneJointSurg(Am ) ,1994,76 :980～ 985 .
- 〔9〕 WheelerHG ,AndersonFA .Diagnosticmethodsfordeepveinthrombosis[J] .Haemostasis ,1995 ,2 5 :6～ 2 5 .
- 〔10〕JankuGR ,PaiementGD ,GreenHD .Preventionofvenousthromboembolisminorthopaedicsintheunitedstates[J] .ClinicalOrthopaedics ,1996 ,32 5 :313～ 32 1.
- 〔11〕CoventryMB ,NolanDR ,BeckenbaughRD .“Delayed”pro phylacticanticoagulation :Astudyofresultsandcomplica tionsin 2 0 12totalhiparthroplastics[J] .JBoneJointSurg(Am ) ,1973 ,5 5 :14 87～ 14 92 .
- 〔12〕FerreeBA ,SternPG ,JolsonRS .Deepvenousthrombosisafterspinalsurgery[J] .Spine ,1993 ,18:315～ 319.