全膝置换术后下肢深静脉血栓形成因素的研究进展

摘要/Abstract

摘要： 全膝关节置换术（Total Knee Arthroplasty,TKA）是治疗终末性膝关节疾病的有效手段,能有效根除膝关节疼痛,显著改善患肢术后功能且病死率较低,已被广泛应用于临床。但TKA患者以老年人群为主,且术后容易形成下肢静脉血栓,尤其是深静脉血栓（Deep Vein Thrombosis,DVT）的形成,若栓子脱落会继发肺栓塞,严重威胁患者的生命安全。本文对行TKA患者术后发生下肢DVT 的危险因素进行了综述,以期为TKA术后DVT形成的防治提供更多依据。

关键词: 全膝关节置换术, 下肢深静脉血栓, 危险因素, 老年

Abstract: Total knee arthroplasty (TKA) is an effective method for treating terminal knee joint diseases, which can effectively eliminate knee joint pain, significantly improve postoperative function of the affected limb, and have a low mortality rate. It has been widely used in clinical practice. However, TKA patients are mainly elderly and are prone to developing lower limb venous thrombosis, especially deep vein thrombosis (DVT), after surgery. If the thrombus falls off, it can lead to secondary pulmonary embolism, seriously threatening the patient's life safety. This article reviews the risk factors for lower limb DVT in patients undergoing TKA surgery.

Key words: total knee arthroplasty, lower limb deep vein thrombosis, risk factors, old age

中图分类号:

R687.4

崔宇浩, 黄立新. 全膝置换术后下肢深静脉血栓形成因素的研究进展[J]. 中华养生保健, 2024, 42(23): 66-69.

CUI Yu-hao, HUANG Li-xin. Research Progress on Factors of Lower Extremity Deep Vein Thrombosis after Total Knee Replacement[J]. ZHONGHUA YANGSHENG BAOJIAN, 2024, 42(23): 66-69.

参考文献

[1] 文材,尹立.人工膝关节置换术的发展概况与进展[J].中国医药指南,2018,16(31):31-34.
[2] KLEM N R, SMITH A, O'SULLIVAN P, et al. What influences patient satisfaction after TKA? A qualitative investigation[J]. Clin Orthop, 2020, 478(8):1850-1866.
[3] DAI W L, LIN Z M, SHI Z J, et al.Venous thromboembolic events after total knee arthroplasty: Which patients are at a high risk[J]. J Knee Surg,2020, 33(10):947-957.
[4] ZHANG S, HTET K S, TAN X Y, et al.Short-duration chemoprophylaxis might reduce incidence of deep vein thrombosis in Asian patients undergoing total knee arthroplasty[J]. Knee Surg Relat Res,2020,32(1):58.
[5] 孙健平,王鹏飞,薛汉中,等.多发伤患者围手术期深静脉血栓形成的发生及危险因素[J].中华创伤骨科杂志,2019,21(1):39-43.
[6] PIOVELLA F, WANG C J, LU H, et al.Deep-vein thrombosis rates after major orthopedic surgery in Asia. An epidemiological study based on postoperative screening with centrally adjudicated bilateral venography[J].J Thromb Haemost,2005,3(12):2664-2670.
[7] 桂锐,周伟,王孝高等.下肢深静脉血栓发生肺栓塞的危险因素分析及Nomogram模型的构建[J].国际检验医学杂志,2023,44(23):2897-2901.
[8] 杨婧. 股骨颈骨折行髋关节置换术围手术期下肢深静脉血栓形成的影响因素[J].透析与人工器官,2023,34(3):49-52.
[9] 周瑞华. 下肢骨折形成深静脉血栓的危险因素及预防措施[J].临床医药实践,2015,24(4):310-312.
[10] 索南昂秀,周京元,祁腾民,等.体质量指数及年龄对人工关节置换术后下肢深静脉血栓形成的影响[J].中国医药导报,2017,14(33):90-93.
[11] 曾保尧,王斌强,左江伟.不同年龄和性别下肢深静脉血栓形成危险因素分析[J].中国现代医药杂志,2020,22(8):12-18.
[12] BLONDON M, HARRINGTON L B, BOEHLEN F, et al.Pre-pregnancy BMI, delivery BMI,gestational weight gain and the risk of postpartum venous thrombosis[J]. Thromb Res,2016,145:151-156.
[13] 倪浩伦. 髂静脉狭窄与下肢深静脉血栓形成关系研究[D].南京:南京大学,2021.
[14] 桂海枝,王莉,高成钢,等.下肢骨折术后深静脉血检形成的影响因素分析[J].血管与腔内血管外科杂志,2023,9(6):726-730.
[15] 耿倩,李天华,鹿青,等.骨科住院患者下肢深静脉血栓形成的发生率及危险因素分析[J].护士进修杂志,2021,36(9):817-820.
[16] AGENO W, BECATTINIC, BRIGHTONT, et al.Cardiovasculai risk factors and venous thronboembolism:A meta-analysis[J].Circulation,2008,117(1):93-102.
[17] 王焱,付改莉,孙银侠.风险护理在糖尿病患者下肢深静脉血栓形成护理中的应用及对患者血流动力学的影响[J].血栓与止血学,2019,25(5):886-887.
[18] SIVRITEPE R, BASAT S, ORTABOZ D.Association of vitamin D status and the risk of cardiovascular disease as assessed by various cardiovascular risk scoring systems in patients with type 2 diabetes mellitus[J]. The Aging Male,2019,22(2):156-162.
[19] 张伟,张俊峰,王觅,等.体表慢性难愈合创面患者下肢深静脉血栓形成的发生情况及影响因素[J].中华医学杂志,2020,100(4):291-294.
[20] 李强,张学江,侯钦茂.60岁以上2型糖尿病患者下肢深静脉血栓形成的影响因素[J].中国卫生工程学,2022,21(6):1027-1028,1031.
[21] TEKA S, KINDE S, DEDEFO G, et al.Hypogonadism and associated risk factors in male patients with type 2 diabetes mellitus attending the diabetic clinic of Tikur Anbessa Specialized Teaching Hospital,Addis Ababa,Ethiopia[J]. Journal of Endocrinology, Metabolism and Diabetes of South Africa,2019,24(1):16-22.
[22] 黄军刚,王文己,赵月生.膝关节置换术后深静脉血栓的研究进展[J].西北国防医学杂志,2018,39(9):625-630.
[23] 仇丽珍. 骨科术后高脂血症患者下肢静脉血栓的预防及护理[J].河南大学学报(医学版),2020,39(3):214-216.
[24] 杜开会. 脊柱转移瘤术后下肢静脉血栓形成的危险因素分析[D].长沙:中南大学,2022.
[25] 罗娟. 乳腺癌术后发生下肢深静脉血栓的危险因素及血栓风险评估[J].双足与保健,2019,19(11):125-126.
[26] 费晨,王鹏飞,魏巍,等.髋部骨折患者远端深静脉血栓的解剖分布及变化规律[J].国际外科学杂志,2019,46(7):471-476.
[27] PAFFRATH T, WAFISAD A, LEFERING, et al. Venous thromboembolism after sever traum: Incidence, risk factors and outcome[J]. Injury,2010,41(1):97-101.
[28] 张强. 麻醉方式对全膝关节置换术后深静脉血栓发生率的影响[J].中国实用医刊,2016,43(23):61-63.
[29] 杭博,曾渊.全膝关节置换术不同麻醉方式对术后深静脉血栓形成的影响[J].血栓与止血学,2019,25(6):1002-1003.
[30] GUAY J, PARKER M J, GAJENDRAGADKAR P R, et al.Anaesthesia for hip fracture surgery in adults[J]. Cochrane Database Syst Rev,2016,2(2):CD000521.
[31] 张麟,凃峰,吕龙,等.全膝关节置换术中止血带不同使用策略对下肢深静脉血栓高危诱发因素的影响[J].华中科技大学学报(医学版),2021,50(5):640-644.
[32] 梁燕,邵永强.术中止血带不同充气间断时间对老年高血压行TKA术后患者下肢深静脉血栓及凝血功能的影响[J].包头医学院学报,2020,36(11):64-66.
[33] 罗翠芳,欧阳莉,吴晶.全髋关节置换术后下肢深静脉血栓形成的影响因素及其预防[J].青岛医药卫生,2023,55(1):25-28.