中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (17): 3054-3057.doi: 10.3969/j.issn.1673-8225.2010.17.004

• 骨与关节循证医学 evidence-based medicine of the bone and joint • 上一篇    下一篇

全髋关节置换后早期并发深静脉血栓的多因素Logistic回归分析

臧学慧1，查振刚2，冯永洪3，高立华1，孙  辉1   

  1. 1南方医科大学附属南海医院，广东省佛山市  528200；2暨南大学附属第一医院，广东省广州市   510632；3东莞市中医院，广东省东莞市  523005
  • 出版日期:2010-04-23 发布日期:2010-04-23
  • 作者简介:臧学慧★，男，1975年生，内蒙古自治区丰镇市人，汉族，2005年暨南大学毕业，硕士，主治医师，主要从事关节外科方面的研究。 zangxh2008@163.com

Multi-factor binary Logistic regression for early deep venous thrombosis following total hip replacement 

Zang Xue-hui1, Zha Zhen-gang2, Feng Yong-hong3, Gao Li-hua1, Sun Hui1   

  1. 1 Nanhai Hospital, Southern Medical University, Foshan   528200, Guangdong Province, China; 2 First Affiliated Hospital of Jinan University, Guangzhou   510632, Guangdong Province, China; 3 Dongguan Hospital of Traditional Chinese Medicine, Dongguan   523005, Guangdong Province, China
  • Online:2010-04-23 Published:2010-04-23
  • About author:Zang Xue-hui★, Master, Attending physician, Nanhai Hospital, Southern Medical University, Foshan 528200, Guangdong Province, China zangxh2008@163.com

PDF

673

被引次数

79

摘要：

背景：随着对全髋关节置换后并发深静脉血栓的认识加深，减少和避免其发生已成为临床面临的重要课题。以往对影响深静脉血栓形成的相关因素报道虽多，但着眼点片面、样本量过少、统计学意义差、基础试验与临床研究的结果相混淆、研究方法及设计缺乏科学性，造成报道不一致，各抒己见。
目的：探讨全髋关节置换术早期并发深静脉血栓的原因及其相关因素，并提出预防与处理对策，从而降低发生率。
方法：回顾分析1 780例首次全髋关节置换术病例，选择性别、年龄、体质量、病种、合并症、患髋既往手术、麻醉、手术时间、假体固定方式、输血、术后患肢训练、防血栓药物、并发症指标进行统计，采用SPSS建立标准化数据库，行Logistic多因素回归分析。
结果与结论：1 780例全髋关节置换患者中有深静脉血栓136例。年龄、合并症、麻醉、假体固定方式、输血、患肢术后主被动训练、防血栓药物因素与深静脉血栓有相关性(P < 0.05)。高龄、高血压或糖尿病、全麻、骨水泥固定、输全血是全髋关节置换术早期并发深静脉血栓的危险因素，患肢术后主被动训练、防血栓药物应用是保护因素。认真做好围手术期处理，积极控制慢性合并症、术前做好评估、术中操作精细、术后积极预防治疗及护理可以降低深静脉血栓的发生。

关键词: 深静脉血栓, 全髋关节置换, 相关因素, Logistic回归分析, 髋关节假体

Abstract:

BACKGROUND: With further understanding of deep venous thrombosis (DVT) following total hip replacement, reduction and prevention of DVT has become hot topic in clinical studies. The reports of DVT formation factors remain controversial due to small samples, little statistical significance, confusion of basic experimental and clinical results and lacks of science.
OBJECTIVE: To explore the causes and factors for the early DVT following total hip replacement and summarize measures to prevent and treat early DVT to reduce incidence of complications.
METHODS: A total of 1 780 cases of primary total hip replacement operation were analyzed retrospectively. The statistical indexes included sex, age, body mass, other system disease, previous hip joint operation, anesthesia, operative time, prosthetic fixation, blood transfusion, postoperative functional exercise, antithrombotics, and complication. Standardized database was built and analyzed by SPSS (version 13). Regression analysis was performed using Binary Logistic Regression.
RESULTS AND CONCLUSION: Of 1 780 cases, 136 had DVT. Age, other system diseases, anesthesia, prosthetic fixation, blood transfusion, postoperative functional exercise and antithrombotics were correlated with early DVT (P < 0.05). Old age, hypertension or diabetes, general anesthesia, fixation of bone cement, whole blood transfusion were the risk factors for early DVT following total hip replacement, while postoperative functional exercise and antithrombotics were the protective factors for DVT. The incidence rate of early complications can be reduced by the methods such as dealing with perioperative treatment carefully, effectively controlling the chronic diseases, efficient evaluation before surgery, precise manipulation, and the postoperative prophylactic treatment and nursing.

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