首页 > 硕士 > 医学 > 正文

关节置换术后深静脉血栓的发病率及初步研究

Incidence Rate and Preliminary Study of Deep Vein Thrombosis after Joint Replacement

作者: 专业:骨外科 导师:蒋青 年度:2010 学位:硕士  院校: 南京医科大学

Keywords

deep vein thrombosis, joint replacement, incidence rate, preliminary study

        目的探讨关节置换术后深静脉血栓的发生率和部分相关影响因素。方法对我科2007年5月至2009年8月行生物型THR的患者和水泥型TKR的患者,记录患者的相关资料,症状和体征。术后3-6天对患肢行数字化下肢深静脉顺行性造影,明确血栓部位和大小。生物型THR的患者240例,其中男85例,女155例;年龄22-86岁,平均63.4+14.27岁。水泥型TKR的患者105例,其中男20例,女85例;年龄29-87岁,平均67.12+ 8.09岁。依据是否形成血栓分为血栓组和非血栓组。对于生物型THR的患者,将不同病种的发病率以及血栓组与非血栓组的手术时间,脂代谢指标进行比较。对于水泥型TKR的患者,将血栓组与非血栓组的术中膝关节温度进行比较。结果生物型THR和水泥型TKR后DVT的发生患者各为65例和46例,其中有临床依据者分别为15例和30例。对于生物型THR的患者,股骨颈骨折患者发生率高,但无显著性区别(p>0.05),血栓组手术时间长(p<0.05),胆固醇水平高(p<0.05)。对于水泥型TKR的患者,在骨水泥硬化过程中,腘窝初始温度为29.4±0.7℃,最高温度为32.5±1.0℃,始终低于体温。血栓组和非血栓组的腘窝温度无显著性区别(p>0.05)。结论生物型THR和水泥型TKR的术后DVT的发生率分为27.08%(65/240)和43.81%(46/105),其中有临床依据的各占23.1% (15/65)和65.2% (30/46)对于生物型THR,胆固醇和手术时间与DVT的发生有关。对水泥型TKR,骨水泥的聚合热不造成膝周血管的直接损伤,和DVT的发生无直接关系。
    Objective To investigate the incident rate(IR), partly related influence factors ofdeep vein thrombosis(DVT)after total hip replacement(THR) and total kneereplacement (TKR).Methods From May 2007 to August 2009, patients with uncemented THR orcemented TKR were underwent digitizing deep vein anterograde venography of theoperated lower limb 3-6 days after joint operation, in order to find the location andsize of thrombus.Related document, symptom and sign were recorded.There were240 uncemented THR patients,including 85 males and 155 females), age were 22-86(63.4+ 14.27). There were 105 cemented TKR patients,including 20 males and 85females, age were 29-87 (67.12+ 8.09).The patients were divided into DVT groupand Non–DVT group according to whether the DVT had formed . For uncementedTHR The incident rate of disease kind and the operation time and the levels oflipidmetabolism of these two groups were statistically compared. For cement TKRthe temperatures at the knee of these two groups in the operation were statisticallycompared.Results The number of DVT after uncemented THR and cemented TKR were 65and 46.There were 15 THR patients and 30 TKR patients who had clinical evidences.For uncemented THR The time of operation and level of cholesterin weresignificantly longer and higher in DVT group. Hip fracture patients had the highestincident rate of DVT . bur there is no significant difference (p>0.05).For cementTKR The initial temperatures of the popliteal fossa were 29.4±0.7℃,the maximumtemperature were 32.5±1.0℃,always lower than the body temperature.No significantdifference was found of the temperatures in the popliteal fossa between the DVTgroup and the Non-DVT group (p>0.05).Conclusio The incident rate of DVT after uncemented THR and cemented TKRwere 27.08%(65/240)and 43.81%(46/105),The incident rate of clinical evidenceswere23.1% (15/65)和65.2% (30/46)。There is relationship between cholesterol,operation time and DVT. Polymerization of the cement is not be a cause of directdamage to the veins surrounding the knee and it has no direct relationship with DVT.
        

关节置换术后深静脉血栓的发病率及初步研究

缩略词中英文对照4-5
中文摘要5-6
Abstract6-7
前言8-16
    一﹑ 关节置换术后深静脉血栓的定义和病因8
    二﹑ 关节置换术后DVT的发病率8-9
    三﹑ DVT的诊断进展9-10
    四﹑ 生物型THR后DVT的形成的原因10
    五﹑ 水泥型TKR后DVT的形成的原因10-11
    六﹑ 关节术后DVT的预防措施11-13
    七﹑ 本研究的创新性和思路13-14
    参考文献14-16
第一部分 生物型全髋关节置换术后深静脉血栓的发病率及初步研究16-29
    资料与方法16-21
    结果21-25
    讨论25-29
第二部分 水泥型全膝关节置换术后深静脉血栓的发病率及初步研究29-37
    材料与方法29-32
    结果32-34
    讨论34-37
结论37-38
参考文献38-42
文献综述42-51
    参考文献48-51
附录一:个人简历51-52
附录二:攻读学位期间学术成果52-54
致谢54-55
        下载全文需50


本文地址:

上一篇:雄激素受体辅调节因子在前列腺癌内分泌治疗中的预测意义
下一篇:培养基血清浓度对人表皮干细胞增殖分化的影响

分享到: 分享关节置换术后深静脉血栓的发病率及初步研究到腾讯微博           收藏
评论排行
公告