林才渊,李志鹏,张志广,夏天卫,张富城,沈计荣

• 1:南京中医药大学附属医院

摘要(Abstract)：

[目的]探讨加速康复下下肢关节置换术后深静脉血栓（deep vein thrombosis, DVT）形成的相关因素。[方法] 2021年12月—2022年12月于本院行下肢关节置换的330例患者纳入本研究，观察术后DVT的发生情况，采用单因素和多因素二元逻辑回归分析探索DVT形成的相关因素。[结果]330例患者中，术后46例患者被诊断为下肢深静脉血栓，血栓总体发生率为13.9%。血栓组患者年龄[(71.9±7.2)岁vs (64.4±14.2)岁, P<0.001]、女性占比[男/女,(7/39) vs (84/200), P=0.046]、脑梗史占比[是/否,(12/34) vs (32/252), P=0.006]及病因为OA患者占比[CD/ON/OA/RA/FX,(5/2/35/0/4) vs (42/50/157/10/25), P=0.048]、术前CRP [(9.3±8.2) mg/L vs (3.5±3.2) mg/L, P<0.001]、术后第1 d CRP [(21.4±18.5) mg/L vs (14.7±12.8) mg/L, P=0.004]显著高于非血栓组，但术中失血量[(322.2±225.4) ml vs (432.9 298.6) ml, P=0.005]显著少于非血栓组，术式为UKA、TKA、AFHR的患者占比[UKA/TKA/AFHR/THA,(13/22/2/9) vs (67/82/10/125), P=0.013]显著高于非血栓组。多因素二元逻辑回归结果显示：饮酒史（OR=5.041, P=0.046）、术前CRP (OR=1.173, P=0.031)、年龄（OR=1.078, P<0.001）是下肢关节置换术后发生DVT的独立危险因素。[结论]在加速康复理念指导下下肢关节置换术后，除外肌间静脉血栓，下肢其余类型深静脉血栓发生率较低。饮酒史、术前CRP、年龄是下肢关节置换术术后DVT发生的独立危险因素。

关键词(KeyWords)： 下肢关节置换;加速康复;深静脉血栓;危险因素

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 林才渊,李志鹏,张志广,夏天卫,张富城,沈计荣

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