中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (22): 4050-4052.doi: 10.3969/j.issn.1673-8225.2010.22.014

• 骨科植入物 orthopedic implant • 上一篇    下一篇

全髋关节置换后深静脉血栓栓塞与APACHEⅡ评分：98例资料回顾

赵金柱1，宋展昭2，胡  健2，徐  朋2，孙培峰2，陶春生2，陈  君2   

  1. 1青岛大学医学院研究生院，山东省青岛市 266071；2解放军401医院骨一科，山东省青岛市    266071
  • 出版日期:2010-05-28 发布日期:2010-05-28
  • 作者简介:赵金柱，男，1978年生，内蒙古通辽市人，蒙古族，2002年解放军第二军医大学毕业，主治医师，主要从事关节外科研究。jinzhu_zh@126.com
  • 基金资助:

    解放军第401医院院内立项课题。

Venous thromboembolism following total hip replacement and acute physiology and chronic health evaluation scores: A retrospective analysis of 98 cases

Zhao Jin-zhu1, Song Zhan-zhao2, Hu Jian2, Xu Peng2, Sun Pei-feng2, Tao Chun-sheng2, Chen Jun2   

  1. 1 Graduate School of Qingdao University Medical College, Qingdao  266071, Shandong Province, China; 2 First Department of Orthopedics , the 401 Hospital of Chinese PLA, Qingdao  266071, Shandong Province, China
  • Online:2010-05-28 Published:2010-05-28
  • About author:Zhao Jin-zhu, Attending physician, Graduate School of Qingdao University Medical College, Qingdao 266071, Shandong Province, China jinzhu_zh@126.com
  • Supported by:

    a Grant from the 401 Hospital of Chinese PLA *

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摘要：

背景：全髋关节置换后发生深静脉血栓栓塞的发生存在多种危险因素，且涉及多个临床学科，目前尚缺乏系统、可靠的评分预测系统。但临床上早期可以通过深静脉多普勒超声来判断其发生情况。急性生理学与慢性健康评定标准(APACHEⅡ)在国内外已被广泛用于对ICU危重患者病情严重程度的分析和预后评估。
目的：评价APACHEⅡ评分与全髋关节置换后深静脉血栓栓塞的相关性。
方法：回顾性分析2000/2005解放军401医院全髋关节置换病例98例(106髋)的动态APACHEⅡ评分，包括置换前、发生深静脉血栓时及出现肺栓塞时，比较深静脉血栓栓塞症发生组与未发生组的APACHEⅡ评分差异，以及深静脉血栓栓塞症患者中发生肺栓塞组与未发生肺栓塞组的APACHEⅡ评分差异。
结果与结论：发生深静脉血栓栓塞症组与未发生深静脉血栓栓塞症组置换前APACHEⅡ评分差异无显著性意义(P > 0.05)。深静脉血栓栓塞症患者中肺栓塞组APACHEⅡ评分明显高于未发生肺栓塞组(P < 0.05)。提示APACHEⅡ评分与早期深静脉血栓栓塞症的发生无明显相关性；但深静脉血栓栓塞症发生后，APACHEⅡ评分与肺栓塞发生有相关性，且APACHEⅡ评分分值越高，肺栓塞发生风险越大。

关键词: 全髋关节置换, APACHEⅡ评分, 深静脉血栓栓塞症, 肺栓塞, 相关性

Abstract:

BACKGROUND: There are many risk factors for venous thromboembolism (VTE) following total hip replacement, which involves several clinical subjects. There remains no systematic and reliable evaluation system. Frequently, Doppler ultrasound has been used to identify VTE. Acute physiology and chronic health evaluation (APACHE Ⅱ) has been widely used for severity degree and prognosis evaluation of ICU patients.
OBJECTIVE: To evaluate the correlation between APACHEⅡ scoring and VTE after total hip replacement. 
METHODS: APACHE Ⅱ scores (preoperative, VTE and pulmonary thromboembolism, PTE) of 98 patients (106 hip joints) who were treated by total hip replacement in the 401 Hospital of Chinese PLA from 2000 to 2005 were analyzed retrospectively. The APACHE Ⅱ scores were compared between the VTE group and non-VTE group, as well as PTE group and non- PTE group.
RESULTS AND CONCLUSION: There were no significances in APACHE Ⅱ scores between VTE group and non-VTE group   (P > 0.05). The APACHE Ⅱ scores were significantly greater in PTE group compared with non-PTE group (P < 0.05). Results show that there is no correlation between APACHE Ⅱ and VTE in early stage; but the APACHE Ⅱ scores were correlated with PTE following VTE. Moreover, the higher the APACHE Ⅱ scores, the greater risk for PTE is.

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