老年膝关节单髁置换术后发生下肢深静脉血栓的危险因素分析与护理对策

目的探讨老年膝关节单髁置换术后发生下肢深静脉血栓(DVT)的危险因素与护理对策。方法选取2016年2月至2017年3月在我院行膝关节单髁置换术患者158例(158膝)为研究对象,收集其年龄、性别、体质量指数(BMI)、糖尿病史、高血压史、饮酒史、激素类药物治疗史、手术时间、术中出血量、凝血功能指标、假体类型、机械抗凝类型等资料,采用单因素分析及多因素logistic回归分析老年膝关节单踝置换术后发生DVT的相关因素。结果多因素logistic回归分析显示,年龄≥66岁、女性、BMI≥28 kg/m^2、糖尿病史、使用骨水泥型假肢、机械抗凝中未使用血液循环泵是老年膝关节单髁置换术后发生DVT的独立危险因素(P <0. 05)。结论老年膝关节单踝置换术后发生DVT的影响因素较多,应针对性实施护理对策,降低DVT发生率。

Analysis of the risk factors of lower limb deep venous thrombosis and nursing countermeasures in elderly patients undergoing unicondylar knee arthroplasty

Objective To investigate the risk factors of lower limb deep venous thrombosis( DVT) and nursing countermeasures in elderly patients undergoing unicondylar knee arthroplasty. Methods To select 158 cases of patients( 158 knees) who underwent unicondylar knee arthroplasty in our hospital from February 2016 to March 2017 as the study subjects,and their age,gender,body mass index( BMI),history of diabetes,history of hypertension,history of alcohol consumption,and history of hormones drug treatment,operation time,intraoperative blood loss,coagulation function index,prosthesis type,mechanical anticoagulation type and other data were collected. Univariate analysis and multivariate logistic regression were used to analyze the related factor of lower limb DVT in elderly patients undergoing unicondylar knee arthroplasty. Results Multivariate logistic regression analysis showed that the age≥66 years old,female,BMI≥28 kg/m^2,history of diabetes,use of bone cement prosthesis,and no use of blood circulation pump in mechanical anticoagulation were independent risk factors for DVT after elderly patients undergoing unicondylar knee arthroplasty( P < 0. 05). Conclusion There were many influential factors for DVT in elderly patients undergoing unicondylar knee arthroplasty. Nursing measures should be implemented to reduce the incidence of DVT.