目的：探讨人工髋关节和膝关节置换术后深静脉血栓（下肢深静脉血栓形成,DVT）的预防措施。方法30例拟接受髋膝关节手术的患者行彩色多普勒超声检测，双下肢无深静脉血栓形成，术后采用1、利伐沙班2、低分子肝素分别抗凝治疗为主、机械预防措施为辅的方法。术后3d再次给予彩色超声多普勒检查，必要时合并下肢深静脉造影，确诊为腘静脉以上的D V T，给予溶栓或手术治疗。结果术后5例形成D V T，发生率为16.67%，均无症状性肺栓塞。结论人工髋膝关节置换术前要优先使患者合并症得到有效治疗，术中采用全麻或腰硬联合麻醉，术后给予利伐沙班或低分子肝素同时联合机械预防的方法，可以有效的预防术后DVT的发生率。
The prevention of deep venous thrombosis after hip and knee arthroplasty
Objective To explore the prevention of deep venous thrombosis (DVT)after hip and knee arthroplasty . Methods30 cases intending hip and knee replacement were diagnosed using ultrasound and color doppler flow imaging and there were no thrombosis in deep veins of lower limbs .Low molecular weight heparin or rivaroxaban were given respectively to anticoagulant therapy after the surgery and mechanical preventive measures were used adjuvantly.Ultrasound and color doppler flow imaging were diagnosed combined with deep vein angiography when necessary three days after the operation ,and thrombolysis or surgery therapy were applied to whom definitely diagnosed DVT above the popliteal vein .Results Five patients were suffered from DVT, the incidence was 16.67% and there were no symptomatic pulmonary embolism.Conclusion there are three key points to prevent the occurrence of DVT in hip and knee arthroplasty:preoperative effective treatment should be given to the patients to relieve the complications,general anesthesia or combined spinal epidural anesthesia were used during the operation ,and then low molecular weight heparin or rivaroxaban were applied respectively combined with mechanical preventive measures to anticoagulant therapy after the surgery .
Hip and knee arthroplastyDeep venous thrombosisIncidence rate
NETL
NSTL
万方数据
