[1]夏志强,周强,李颖,等.老年膝关节置换围手术期深静脉血栓形成因素分析及其血清预测因子分析[J].中华老年骨科与康复电子杂志,2022,(06):361-366.[doi:10.3877/cma.j.issn.2096-0263.2022.06.007]
　Xia Zhiqiang,Zhou Qiang,Li Ying,et al.Analysis of perioperative deep venous thrombosis in elderly patients with knee arthroplasty and analysis of serum predictors[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2022,(06):361-366.[doi:10.3877/cma.j.issn.2096-0263.2022.06.007]
点击复制

老年膝关节置换围手术期深静脉血栓形成因素分析及其血清预测因子分析()
分享到：

中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2022年06期
页码:
361-366
栏目:
深静脉血栓
出版日期:
2022-12-05

文章信息/Info

Title:
Analysis of perioperative deep venous thrombosis in elderly patients with knee arthroplasty and analysis of serum predictors
作者:
夏志强; 周强; 李颖; 李飞龙; 赵磊; 王肇炜; 朱晓曼
210001 南京，中国人民解放军东部战区空军医院
Author(s):
Xia Zhiqiang;  Zhou Qiang;  Li Ying;  Li Feilong;  Zhao Lei;  Wang Zhaowei;  Zhu Xiaoman.
The Air Force Hospital of the Eastern Theater Command of the Chinese People’s Liberation Army, Nanjing 210001, China
关键词:
老年人;  膝关节置换;  深静脉血栓形成;  风险因素;  D-二聚体
Keywords:
Aged;  Knee replacement;  Deep vein thrombosis;  Risk factors;  D-dimer
DOI:
10.3877/cma.j.issn.2096-0263.2022.06.007
文献标志码:
A
摘要:
目的 分析老年全膝关节置换围手术期合并深静脉血栓（DVT）独立的风险因素，探讨D-二聚体（D-Dimer）、红细胞沉降率（ESR）和C-反应蛋白（CRP）对DVT的预测价值。方法 回顾性选取2016年1月至2021年7月期间本院骨外科接受全膝关节置换手术的160例老年患者，根据围手术期是否发生DVT分为DVT组和无DVT组。单因素和Logistic多因素分析DVT的独立危险因素，进一步绘制受试者特征（ROC）曲线，根据曲线下面积（AUC）确定ESR、CRP、D-Dimer预测DVT的临界值。结果 DVT组患者术后的血清ESR、CRP、D-Dimer水平均显著高于无DVT组（P＜0.05），年龄、BMI、手术时间、术后卧床时间、ESR、CRP、D-Dimer值均为老年患者术后DVT形成的重要危险因素（P＜0.05）；Logistic回归分析发现，年龄＞80岁、BMI＞30 kg/m2、术后卧床时间≥5 d、术后ESR、CRP、D-Dimer是DVT形成独立的风险因素（P＜0.05）；ROC曲线结果示，CRP、D-Dimer、ESR的AUC分别为0.739、0.893、0.725，对DVT具有较好的预测价值（P＜0.05）。结论 老年膝关节置换术后下肢DVT的发生与年龄、BMI、手术时间、术后卧床时间、术后血清ESR、CRP、D-Dimer水平等密切相关，术后检测血清ESR、CRP、D-Dimer水平对DVT的预测效果较好，具有一定的临床应用价值。
Abstract:
Objective To analyze the independent risk factors of deep vein thrombosis (DVT) in the perioperative period of total knee arthroplasty in the elderly, and to explore D-dimer (D-Dimer), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) for the predictive value of DVT. Methods A total of 160 elderly patients who underwent total knee arthroplasty in the Department of Orthopaedic Surgery of our hospital from January 2016 to July 2021 were retrospectively selected and divided into DVT group and no DVT group according to whether DVT occurred in the perioperative period. The independent risk factors of DVT were analyzed by univariate and logistic multivariate, and the receiver characteristic (ROC) curve was further drawn, and the critical value of ESR, CRP and D-Dimer for predicting DVT was determined according to the area under the curve (AUC). Results The postoperative serum ESR, CRP and D-Dimer levels of the patients in the DVT group were significantly higher than those in the non-DVT group (P<0.05). Important risk factors for postoperative DVT in elderly patients (P<0.05); Logistic regression analysis found that age>80 years old, BMI>30kg/m2, postoperative bed rest time ≥5d, postoperative ESR, CRP and D-Dimer were independent risk factors for DVT (P<0.05). The ROC curve results showed that the AUCs of CRP, D-Dimer and ESR were 0.739, 0.893, and 0.725, respectively, which had good predictive value for DVT (P<0.05). Conclusion The occurrence of lower extremity DVT after knee arthroplasty in the elderly is closely related to age, BMI, operation time, postoperative bed rest time, postoperative serum ESR, CRP, D-Dimer levels, etc. The serum ESR, CRP, D-Dimer levels were detected after surgery The prediction effect of DVT is good, and it has certain clinical application value.

相似文献/References:

[1]赵晨,商培洋,车凌宾,等.锁定钢板治疗老年肱骨近端骨折合并肩袖撕裂的疗效分析[J].中华老年骨科与康复电子杂志,2015,(01):22.
[2]吴斗,郝海虎,朱剑,等.老年髋部骨折术后谵妄的危险因素分析[J].中华老年骨科与康复电子杂志,2015,(01):34.
[3]高文双,曹建业,吴卫卫,等.墙壁拉力器训练对老年下腰背痛的疗效研究[J].中华老年骨科与康复电子杂志,2015,(01):39.
[4]姬晨妮,陈伟,朱燕宾,等.京津唐地区1 583例老年股骨转子间骨折流行病学特征分析[J].中华老年骨科与康复电子杂志,2015,(01):45.
[5]李石伦,鞠林林,陈伟,等.老年脊柱骨折的流行病学特征分析[J].中华老年骨科与康复电子杂志,2015,(01):50.
[6]杨延江　董天华　杜晨光　杨宗酉　陈伟　吕红芝　刘磊　孙家元　王海立　殷兵　 刘勃 刘松　张英泽.2008 年至2012 年河北医科大学第三医院 老年踝关节损伤的流行病学研究[J].中华老年骨科与康复电子杂志,2015,(02):35.[doi:10.3877/cma.j.issn.2096-0263.2015.02 .007]
　Yang Yanjiang,Dong Tianhua,Du Chenguang,et al.Epidemiological analysis of elderly ankle injury in the Third Hospital of Hebei Medical University from 2008 through 2012[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2015,(06):35.[doi:10.3877/cma.j.issn.2096-0263.2015.02 .007]
[7]吕厚辰,唐佩福.老年髋部骨折患者死亡风险评价[J].中华老年骨科与康复电子杂志,2016,(02):109.[doi:10.3877/cma.j.issn.2096-0263.2016.02.009]
　Lyu Houchen,Tang Peifu..Advancement of mortality prediction of aged hip fracture patients[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(06):109.[doi:10.3877/cma.j.issn.2096-0263.2016.02.009]
[8]高延征,张广泉,邢帅,等.经皮椎体成形术与经皮椎体后凸成形术治疗老年 Kümmell 病的对比研究[J].中华老年骨科与康复电子杂志,2016,(03):136.[doi:10.3877/cma.j.issn.2096-0263.2016.03.002]
　Gao Yanzheng,Zhang Guangquan,Xing Shuai,et al.Comparative analysis of percutaneous vertebroplasty and percutaneous kyphoplastyon in the treatment of the elderly with Kümmell disease[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(06):136.[doi:10.3877/cma.j.issn.2096-0263.2016.03.002]
[9]于沂阳,刘勃,陈伟,等.2008—2012 年河北医科大学第三医院老年骨折流行病学特征分析[J].中华老年骨科与康复电子杂志,2016,(03):172.[doi:10.3877/cma.j.issn.2096-0263.2016.03.009]
　Yu Yiyang,Liu Bo,Chen Wei,et al.Epidemiological analysis of geratic fractures in the Third Affiliated Hospital to Hebei Medical University from 2008 to 2012[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(06):172.[doi:10.3877/cma.j.issn.2096-0263.2016.03.009]
[10]李玉龙,翁习生,董玉雷.老年全膝关节置换术围手术期并发症影响因素的研究进展[J].中华老年骨科与康复电子杂志,2016,(03):177.[doi:10.3877/cma.j.issn.2096-0263.2016.03.010]
　Li Yulong,Weng Xisheng,Dong Yulei.Research progress of influence factors concerning perioperative complications of total knee arthroplasty in aged patients[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(06):177.[doi:10.3877/cma.j.issn.2096-0263.2016.03.010]

备注/Memo

备注/Memo:
基金项目：北大医学青年科技创新培育基金（BMU2021PYB034）
更新日期/Last Update: 2023-01-04