不同麻醉方案对 TKA 术后深静脉血栓发生的影响

目的：对照研究连续硬膜外麻醉（CEA）和全身麻醉下人工全膝关节置换术（TKA）后深静脉血栓（DVT）的发生率，并探析其各自的临床意义。方法：分析2013年4月～2015年5月在我院接受治疗的68例患者的临床资料。将入选者随机分成 CEA 组和全麻组两组，各34例。比较两组患者的一般资料、术前术后的相关指标以及术前凝血、血小板相关指标以及 DVT 的发生率。结果：两组患者的一般资料无统计学差异。两组患者术中、术后的相关指标间差异均不明显。两组患者术前凝血与血小板比较无统计学差异。DVT 的总发生率为19.1％（13/68），其中单纯远端血栓有12例，近端血栓有1例，无肺栓塞及髂静脉血栓患者。CEA 组的 DVT 发生率明显低于全麻组。结论：CEA 可以显著降低 TKA 后 DVT 的发生率，疗效显著。

The impact of different anesthesia programs on the incidence of deep venous thrombosis after TKA surgery

Objective Our retrospective study was aimed toanalyze the occurrence of DVT after operation of TKA in general anesthesia and CEA, and discuss their clinical significance. Methods Clinical data of 68 patients received treatment at our hos-pitalfrom April, 2013 to May, 2015 was retrospectivelyanalyzed. Patients included were divided into two groups at random, CEA group and general anesthesia group, 34 cases in each group. The general information, the indexes before and after operation, the related indexes of coagulation, platelet before operation and the occurrence of DVT in two groups were compared. Results There was no statistical difference in two groups. The values of the indexes before and after operation in two groups had no statistical difference. The values of the related indexes of coagulation, platelet before operation in two groups had no statistical difference. The total occurrence of DVT was 19.1% (13/68), including 12 cases in simple distal thrombus, 1 cases in proximal thrombus. There was no patients with pulmonary embolism and iliac vein thrombosis. The occurrence of DVT in CEA group was obviously lower than that in general anesthesia group. Conclusion The CEA can significantly increase the occurrence of DVT after opera-tion of TKA. It’s effective.