老年全髋关节置换术后DVT的危险因素

目的 探讨老年行全髋关节置换术后发生深静脉血栓(DVT)的危险因素及预测因子。方法 分析2012年7月至2017年5月在我院首次接受全髋关节置换术治疗的217例髋关节疾病患者的临床资料。入组患者根据术后30d内是否发生DVT分为DVT组和非DVT组。比较两组患者的基线资料、合并症、手术相关指标,血常规、血凝、生化以及血液纤溶相关指标。结果 本研究共纳入217例患者,其中DVT组患者24例,非DVT组患者193例。DVT组患者的年龄、糖尿病、房颤、冠心病比例、手术时间均显著高于非DVT组患者(P<0.05);DVT组患者的Alb、TAFI显著低于非DVT组,而D-二聚体及PAI-1水平则显著高于非DVT组(P<0.05);Logistic多因素回归分析提示PAI-1为DVT发生的独立危险因素(OR：1.19,95%CI:1.05-1.31,P=0.012)。结论 老年全髋关节置换手术患者术前PAI-1水平的升高是术后DVT的独立危险因素。

Plasminogen activator inhibitor-1, a risk factor for deep vein thrombosis in elderly patients after total hip arthroplasty

Objective To investigate potential risk factors and predictors for postoperative deep vein thrombosis (DVT) in elderly patients after total hip arthroplasty. Methods Clinical data of elderly patients with total hip arthroplasty at our hospital from July, 2012 to May, 2017 was retrospectively analyzed. Patients included were divided into two groups according to the occurrence of DVT within postoperative 30 days, DVT group and non-DVT group. The general information, comorbidities, operation associated indexes, blood cell analysis, coagulation, biochemistry and fibrinolysis indexes were compared between two groups. Results A total of 217 patients were finally included into this study, including 24 in DVT group and 193 in non-DVT group. The age, percentage of diabetes, atrial fibrillation, coronary artery disease, the duration of surgery, D-dimer and PAI-1 were significantly higher in DVT group than non-DVT group. The levels of albumin and TAFI were significantly lower in DVT group than non-DVT group. The final logistic regression analysis suggested PAI-1 as an independent risk factor for postoperative DVT. Conclusion The elevated PAI-1 level was an independent risk factor for postoperative DVT in elderly patients after total hip arthroplasty.