【摘要】：目的：探討全膝關(guān)節(jié)置換和全髖關(guān)節(jié)置換術(shù)后周圍型血栓的解剖分布以及評估影響小腿血栓分布的因素。方法：2007年6月至2012年5月,共有172名患者接受初次全膝關(guān)節(jié)置換術(shù)或全髖關(guān)節(jié)置換術(shù)后并在術(shù)后7天內(nèi)經(jīng)下肢靜脈造影診斷為周圍型血栓。記錄所有血栓累及的部位并將血栓分為組A(血栓僅累及一個部位或者一條靜脈)和組B(血栓累及兩條或者兩條靜脈以上)。比較兩組間的血栓分布,并評估影響血栓的因素。結(jié)果：在組A共122名患者中,肌間靜脈是最易累及的部位(70.5%),其次為脛后靜脈(18.9%),腓靜脈(7.6%)。組B(50例)中,腓靜脈和脛后靜脈同時累及共11例,占(22%)；脛后靜脈、腓靜脈和肌間靜脈三者累及8例(16%)。手術(shù)類型影響小腿血栓的分布(p=0.013)。在多元邏輯回歸分析中,全膝關(guān)節(jié)置換的病人累及多條靜脈血栓的概率是全髖關(guān)節(jié)置換術(shù)后的2.326倍(p=0.026,95%CI=0.204-0.904)。結(jié)論：膝髖關(guān)節(jié)置換術(shù)后周圍型血栓中,最常見的部位是肌間靜脈。相比于全髖關(guān)節(jié)置換術(shù),全膝關(guān)節(jié)置換術(shù)后急性期內(nèi)形成的小腿靜脈血栓更容易累及兩條或者兩條以上的靜脈。
[Abstract]:Objective: To investigate the anatomical distribution of peripheral thrombus after total knee arthroplasty (TKA) and total hip arthroplasty (THA) and to assess the factors affecting the distribution of thrombus in the lower leg. Methods: From June 2007 to May 2012, 172 patients underwent primary total knee arthroplasty (TKA) or total hip arthroplasty (THA) and were diagnosed by lower extremity venography within 7 days after surgery. Peripheral thrombosis. All thrombus sites were recorded and divided into group A (thrombus involving only one site or vein) and group B (thrombus involving two or more veins). The distribution of thrombus between the two groups was compared and the factors affecting thrombosis were evaluated. Results: Intermuscular veins were the most easily involved in group A of 122 patients. In group B (50 cases), 11 cases (22%) were involved in both the peroneal vein and the posterior tibial vein, 8 cases (16%) were involved in the posterior tibial vein, the peroneal vein and the intermuscular vein. The risk of multiple venous thrombosis was 2.326 times higher (p = 0.026, 95% CI = 0.204-0.904) after total hip arthroplasty. Conclusion: The most common site of peripheral thrombosis after total hip arthroplasty is the intermuscular vein. Or more than two veins.
【學位授予單位】：南京大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R687.4;R322.7

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