原发性深静脉瓣膜功能不全对全膝关节置换术后下肢深静脉血栓形成的影响

目的 探讨原发性深静脉瓣膜功能不全(PDVI)对全膝关节置换术(TKR)术后深静脉血栓形成的影响.方法 126例TKR患者,术前行彩色多普勒超声检查,记录股总静脉有无反流并记录反流时间,反流时间>1s为静脉瓣膜功能不全(有PDVI组),无反流或反流时间≤1 s为静脉瓣膜功能正常(无PDVI组);术后7 d再对全部患者进行下肢静脉彩色多普勒超声复查,观察有无下肢深静脉血栓(DVT)发生.对两组计量资料采用成组资料χ2检验的方法进行统计学分析.结果 126例患者中,有PDVI组54例,无PDVI组72例,共有50例患者术后发生下肢DVT,总发生率39.7%(50/126).其中,有PDVI组33例患者术后发生下肢DVT,发生率61.1%(33/54);无PDVI组17例患者术后发生下肢DVT,发生率23.6%(17/72);PDVI组下肢深静脉血栓的发生率高于瓣膜功能正常组,两组差异有统计学意义(χ2=21.227,P<0.05).结论 原发性PDVI是TKR术后下肢深静脉血栓发生的危险因素.

Effects of primary deep venous valvular incompetence of lower limb in deep vein thrombus after total knee replacement

Objective To evaluate the effects of primary deep venous valvular incompetence of lower limb (PDVI) to the occurrence of deep vein thrombosis (DVT) after human total knee replacement (TKR). Methods One hundred and twenty-six patients who planed to receive TKR were examined by color doppler flow imaging (CDFI). The patients were divided into 2 groups depending on whether they were found backstreaming in femoral vein or not. When the refluxing time > 1 s, the patients were included in PDVI group; When the refluxing time ≥ 1 s, the patients were included in without PDVI group. In 7 d after opertion all the patients were re-examined by CDFI to find if there was DVT. The results were tested by χ2 statistical analysis. Results Among the 126 patients, 54 had PDVI, and 72 without PDVI. Fifty patients had DVT, total incidence rate 39. 7% (50/126). In PDVI group 33 patients had DVT (61.1%, 33/54) ; In without PDVI group 17 patients had DVT (23.6%, 17/72), which was lower than PDVI group (χ2 = 21. 227, P < 0. 05). Conclusions PDVI may be a risk for occurrence of DVT after TKR.