麻醉方式与全膝关节置换术后深静脉血栓发生率分析

目的]比较全麻与连续硬膜外麻醉下人工全膝关节置换术后深静脉血栓形成的发生率.方法]根据入选标准选择2009年9月～2011年1月入院治疗的72例进行人工全膝关节置换术患者,随机分成2组,其中全麻组36例,硬膜外组36例,平均年龄66岁(50 ～ 80岁).所有患者术后5～7d均采用彩色多普勒超声仪检查深静脉血栓的发生情况.并对2组深静脉血栓发生率进行分析.结果]术后发生深静脉血栓的患者为14例,深静脉血栓发生率为19.44％ (14/72).全麻组发生11例深静脉血栓,发生率为30.56％ (11/36),硬膜外组发生3例深静脉血栓,发生率为8.33％ (3/36),全麻组深静脉血栓发生率明显高于硬膜外组,差异有统计学意义(P＜0.05).结论]采用连续硬膜外麻醉方式对降低人工全膝关节置换术后深静脉血栓的发生率效果明显.

Analysis of the incidence of deep venous thrombosis(DVT) after total knee arthroplasty(TKA) in different anaesthesia methods

Objective]To compare the incidence of DVT after TKA in general anaesthesia and in continuous epidural anaesthesia.Methods]From September 2009 to January 2011,according to the selection criteria,72 patients were selected into this study.The patients were divided randomly into 2 groups:36 in general anaesthesia group and 36 in epidural anaesthesia group with a mean age of 66 years(range 50~80 years).Color Doppler ultrasonography was used to detect DVT of bilateral lower extremities in all patients befor operation and at 5~7 days after operation.And finally the result were used to analyze the incidence of DVT.Results]There were 14 patients who developed DVT after operation.The incidence of DVT in all patients was 19.44%(14/72).The incidence of DVT in general anaesthesia groups was 30.56%(11/36) and the incidence of DVT in continuous epidural anaesthesia groups was 8.33%(3/36).The incidence of DVT in general anaesthesia group were significantly higher than in continuous epidural anaesthesia group(P﹤0.05).Conclusion]Continuous epidural anaesthesia can effectively reduce the incidence of DVT after total knee replacement than those patients who receive general anaesthesia.