全髋关节置换术后深静脉血栓的预防

目的观察低分子肝素及足底静脉泵(A-V泵)系统对全髋关节置换术(THR)患者预防深静脉血栓形成(DVT)的效果。方法选择我院2004年6月～2005年6月行THR的患者40例,20例应用低分子肝素,20例间歇性应用A-V泵。全部患者于术前第1天、第3天及第7天晨测下肢髌上、髌下、踝上10cm周径,术后7d用多普勒超声仪来诊断DVT。结果两组患者术后第1天的下肢周径明显增加(P<0.05),第3天时足底静脉泵组下肢周径明显较低分子肝素组小(P<0.05),7d后两组逐渐缓解,与术前无明显差异。在低分子肝素应用组,4例发生DVT(20%),其中2例为近端血栓、2例为远端血栓;A-V泵组,1例(5%)发生DVT,为近端血栓。两组中血栓总发生率有显著性差异(P<0.05)。结论在全髋关节置换术后,A-V脉冲系统可以显著地降低深静脉血栓的发生率和血栓形成范围。

The Prevention of Deep Vein Thrombosis After the Total Hip Replacements

Objective To evaluate the efficacy of low molecular weight heparin and A-V pump in preventing deep vein thrombosis(DVT)after the total hip replacements(THR).Methods Before operation and 1,3,7 days after operation,the circuit length of 10 cm up and down petala and 10 cm up ankle were measured in two groups.DVT were diagnosised by color doppler flower imagine after 7 days operation.Results lower limb was obviously swelled at the 1st day after operation(P<0.05)and decereased at the 7th day(P>0.05).But at 3th day after operation the circuit length of low limb were lower in A-V pump groups.DVT occurred in 20% of the LMWH patients and in 5% of the A-V pump patients(P<0.05).Conclusion A-V pump can significantly reduce the incidence of deep vein thrombosis after total joint replacement.