摘要
[目的]评价人工关节置换术前患者下肢静脉血栓与肌间静脉扩张的发生情况与相关因素。[方法]回顾2015年3月~2017年7月接受人工膝髋关节置换手术569例患者。术前超声检查测量最大肌间静脉直径并在术后检查下肢静脉血栓发生情况。肌间静脉直径≥5.70 mm定义为肌间静脉扩张,将患者分为扩张组和非扩张组,探讨肌间静脉扩张的相关影响因素。[结果]术前超声检查显示569例患者肌间静脉直径为(5.60±2.40)mm,其中扩张组238例,非扩张组331例。术后超声提示新发血栓36例。扩张组年龄、BMI显著高于非扩张组(P<0.05)。Pearson相关分析表明,患者年龄与肌间静脉直径呈显著正相关(r=0.295,P<0.001);患者BMI与肌间静脉直径呈显著正相关(r=0.249,P<0.001)。逻辑回归表明,高龄(OR=1.036,P<0.001)、高BMI(OR=1.095,P<0.001)、手术类型(OR=0.670,P=0.044)是术前肌间静脉扩张的危险因素。[结论]肌间静脉扩张是人工关节置换人群中一种常见的现象。高龄、大体重指数、膝关节置换术是人工关节置换患者肌间静脉扩张的危险因素。
[Objective]To explore the factors related to deep vein thrombosis(DVT)of lower extremities and intermuscular vein dilatation before total arthroplasty of the major joints.[Methods]A retrospective study was performed on 569 patients who were undergoing primary total knee or hip arthroplasty in our hospital from March 2015 to July 2017.Before operation,sonographic screening was conducted to find DVT and measure the maximal diameter of the intermuscular vein.Based on the criteria that the vein was defined as dilatation as the maximal diameter of the vein proved≥5.7 mm,the patients were divided into the dilatation group and non-dilatation group.The factors related to intermuscular vein dilatation were searched by univariable comparison between the two groups and multivariable logistic regression.[Results]As results of ultrasound examination before operation,the average of muscularve in diameter was(5.6±2.4)mm with 238 in the dialation group and 331 in the non-dialation group.Postoperative ultrasound showed newly DVT occurred in 36 patients.The maximal intermuscular vein diameter was of(7.3±2.6)mm in the DVT patients,whereas(5.4±2.3)mm in the non-DVT patients,which proved of statistical significance(P<0.05).With regard to univariable comparison,the dilatation group had significantly older age and greater BMI than the non-dilatation group(P<0.05).In term of Pearson correlation analysis,the maximal intermuscular vein diameter was positively related to the age(r=0.295,P<0.001),and positively related to the BMI(r=0.249,P<0.001).As result of logistic multiple regression,the age(OR=1.036,P<0.001),BMI(OR=1.095,P<0.001)and knee arthroplasty(OR=0.670,P=0.044)were the risk factors of intermuscular vein dilatation.[Conclusion]The intermuscular vein dilatation is a common phenomenon in the candidates for total arthroplasty of the major joints.Advanced age,great body mass index and knee arthroplasty are the predisposing factors of intermuscular vein dilatation.
作者
姚尧
王业贤
徐志宏
陈东阳
史冬泉
戴进
秦江辉
蒋青
YAO Yao;WANG Ye-xian;XU Zhi-hong;CHEN Dong-yang;SHI Dong-quan;DAI Jin;QIN Jiang-hui;JIANG Qing(Department of Sports Medicine and Adult Reconstructive Surgery,Drum Tower Hospital,School of Medicine,Nanjing University,Nanjing 210008,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2020年第21期1945-1948,共4页
Orthopedic Journal of China
基金
国家自然科学基金面上项目(编号:81871832
81672239)。
关键词
关节置换术
肌间静脉
超声多普勒
静脉血栓
静脉扩张
arthroplasty
intermuscular vein
ultrasonic doppler
venous thrombosis
vein dilatation
