原发病对老年全髋关节置换术后下肢深静脉血栓形成的影响

目的 探讨不同原发病对老年全髋关节置换术后下肢深静脉血栓形成（deep venous thrombosis,DVT）的影响.方法 147例单侧全髋关节置换术病人,根据原发病不同分为两组：骨折组68例,均为股骨颈骨折患者,骨病组79例.术前常规检查血浆部分凝血活酶时间（APTT）、凝血酶原时间（PT）、凝血酶凝固时间（thrombin time,TT）、纤维蛋白原（fibrinogen,Fib）含量;对术后出现患肢肿胀和/或疼痛,下肢伴有或不伴有Homans征/Neuhofs征阳性的患者常规应用加压超声技术进行超声多谱勒检查.结果 骨折组和骨病组的APTT、PT、TT、Fib水平及下肢DVT发生率比较具有显著性差异（P＜0.05）.结论 股骨颈骨折是老年全髋关节置换术后下肢DVT发生的高危因素.

Effect of primary diseases on deep venous thrombosis after total hip replacement in the elderly

Objective To explore the effect of primary diseases on deep venous thrombosis (DVT) after total hip replacement in the elderly.Methods 147 patients of unilateral total hip replacement were divided into fracture group (all neck of femur fracture, n=68) and osteopathis group (n=79). Serum activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT) and fibrinogen content were determined before operation. The patients with swelling/pain in affected limb, with or without positive Homans signs/Neuhofs signs in lower limb accepted ultrasonic Doppler using compression ultrasound.Results There were significant differences in APTT, PT, TT, fibrinogen contents and DVT incidence in lower limb (P<0.05).Conclusions Neck of femur fracture is the high risk factor of DVT development in lower limb after total hip replacement in the elderly.