人工全髋关节置换对血液流变学影响的研究

目的探讨人工全髋关节置换术对血液流变学的影响。方法2005年10月至2006年10月，32例因股骨颈骨折行人工全髋关节置换术患者，于手术前1d、手术后1、4、7、14d清晨空腹抽血5mL，用LG—R-80A型血粘度仪检测血流变学各项指标，采用t检验、单因素方差分析手术前后各指标改变。结果血流变学术后明显改变，主要表现在：全血粘度、血浆粘度术后1、4d与术前1d比较无明显变化（P〉0．05），但逐渐升高，术后7d达高峰，差异显著（P〈0．05），术后14d接近术前水平；术后1、4、7d全血还原粘度较术前显著增高（P〈0．05）。术后1d较术前红细胞变形指数明显降低（P〈0．05），刚性指数明显升高（P〈0．05），并于术后4d接近术前水平；红细胞聚集指数、纤维蛋白原术后1、4、7天明显升高（P〈0．05），术后14天接近术前水平。结论人工全髋关节置换术后血液呈高粘滞状态，1周达高峰，两周逐渐恢复。术后早期红细胞流变性显著降低，可能是术后下肢深静脉血栓形成的重要原因之一。

The Study of Blood Rheology after Total Hip Replacement

Objective To study total hip replacement influence to the blood rheology. Methods From October. 2005 to October, 2006,32 patients with total hip replacement for femoral neck fracture were chosen. 5 mL blood of the patients was drawn in the morning of 1 day preperation, 1,4,7,14 days posy-operation. Then blood rheology data was measured with LG-R-80A blood viscosimeter. The data change was analysised by T-test ,around the single factor variance analysis. Results The blood rheology has the obvious change. Main appearances are as follow. The whole blood viscosity,the blood plasma viscosity haven＇t obvious change in 1 day after ＂operation compared with them in 1 day before operazion,but elevates gradually and reaches the peak in 7 days after operation,the difference has statistics significance （P〈0.05）. The data falls to the close them of before operation. In 1.4,7 days after operation, whole blood reduced viscosity increase obviously（P〈0.05）. On 1 day after operation the red blood cell deformation index reduce obviously（P〈0.05） ,the rigid index elevate obviously（P〈0.05）. They are nearly normal on 4 d after operation. Ther red blood cell accumulation index ,the fibrinogen elevate obviously on 1,4,7 days （P〈0.05）, and fall to close to them of pre-operation on 14 days after operation. Conclusion After total hip replacement the blood is in hyperviscous condition. Hyperviscous condition reaches the peak a week after operation and restore gradually two weeks after operation. In early post-operation red blood cell rheological property get bed obviously, which may be one reason of deep vein thrombosis after total hip replacement.