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Objective:To explore the clinical value of one-step CT angiography from deep vein of lower limbs to pulmonary artery in the direction of head and foot.Methods:Twenty-eight patients who presented Haikou Affiliated Hospital of Central South University Xiangya School of Medicine from January 2017 to June 2019 were collected. All patients who underwent one-step CT angiography of the deep veins of the lower extremities to the pulmonary artery were randomly divided into two groups, A or B, and scanned from the entrance of the thorax to 10 cm below the knee joint. Group A was foot-head direction group with delayed time scanning according to empirical method. Group B was the head-foot direction group with a single point triggered automatic tracing scan at the level of the main pulmonary artery trunk. The independent sample t-test was used to compare the scan time, dose length product (DLP), and mean CT value of enhancement of the pulmonary artery opening between the two groups. Results:The average scanning time of the foot-head scanning group was (36.4±1.2)s, the average DLP was (684.4±37.8) mGy·cm, and the average enhanced CT value of pulmonary artery image was (181.3±15.5) HU. The average scanning time of the head foot scanning group was (16.4±0.3) s, the average DLP was (441.8±34.4) mGy·cm, and the average enhanced CT value of the pulmonary artery image was (257.9±24.5) HU. Scanning time, mean DLP, and pulmonary artery level enhancement values were significantly different between the two groups ( t=17.92, 4.71, 2.44, P<0.05). Conclusions:The clinical value of one-step CT angiography from deep vein of lower limbs to pulmonary artery in the head-foot direction is significantly better than that in the head-foot direction. It can significantly shorten the scanning time, reduce the radiation dose, and increase the enhancement value of pulmonary artery to improve the detection of pulmonary embolism.
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Objective:To investigate the characteristics and relationship between the location of lower extremity deep vein thrombosis (DVT) and the site of pulmonary embolism in hospitalized patients.Methods:The data of patients with lower extremity DVT diagnosed by ultrasound examination and pulmonary embolism diagnosed by CT pulmonary angiography from December 2017 to December 2021 were analyzed retrospectively. According to the location of lower extremity DVT, the patients were divided into mixed DVT, proximal DVT, and distal DVT which was further divided into anterior/posterior tibial vein or peroneal vein thrombosis and calf muscular venous thrombosis. Mixed DVT was referred to the presence of both proximal and distal DVT. According to the involved site of pulmonary artery, pulmonary embolism was divided into three types: main pulmonary artery, left or right pulmonary artery trunk embolism, lobar pulmonary artery embolism and segmental pulmonary artery embolism. The location of lower extremity DVT, the site of pulmonary embolism, the clinical manifestation (shortness of breath, chest tightness, chest pain, hemoptysis, cough, lower limb swelling, lower limb pain, syncope, fever) and risk factors (fracture/trauma, tumor, diabetes, hypertension, atrial fibrillation, infection, surgery, autoimmune diseases, paralysis, pregnancy) of venous thromboembolism (VTE), and the level of D-dimer were analyzed.Results:A total of 209 patients were enrolled finally, including 127 patients with left lower extremity DVT (60.8%) and 82 with right lower extremity DVT (39.2%). Mixed DVT accounted for 39.2%, proximal DVT accounted for 17.3%, and distal DVT accounted for 43.5% (anterior/posterior tibial vein and peroneal vein thrombosis accounted for 14.8%, calf muscular venous thrombosis accounted for 28.7%). The incidences of main pulmonary artery embolism, left or right pulmonary artery trunk embolism in the mixed DVT and proximal DVT were significantly higher than those in the anterior/posterior tibial vein or peroneal vein thrombosis and calf muscular venous thrombosis [41.5% (34/82), 38.8% (14/36) vs. 16.2% (5/31), 10.0% (6/60)], with statistically significant differences (all P < 0.05). The incidences of pulmonary segmental artery embolism in the anterior/posterior tibial vein or peroneal vein thrombosis were higher than those in the mixed DVT and proximal DVT [41.9% (13/31) vs. 26.8% (22/82), 30.6% (11/36)], but the difference was not statistically significant (both P > 0.05). The incidences of pulmonary segmental artery embolism in the calf muscular venous thrombosis were significantly higher than those in the mixed DVT and the proximal DVT [66.7% (40/60) vs. 26.8% (22/82), 30.6% (11/36)], and the difference was statistically significant (both P < 0.05). The levels of D-dimer in patients with calf muscular venous thrombosis combined with main pulmonary artery embolism, left or right pulmonary artery trunk embolism were significantly higher than those in patients with calf muscular venous thrombosis combined pulmonary segmental artery embolism (mg/L: 6.08±3.12 vs. 3.66±2.66, P < 0.05). There were no significant differences in D-dimer levels in other patients with DVT combined with pulmonary embolism in different sites. In terms of the clinical manifestations of VTE, the incidences of lower limb swelling in the mixed DVT and proximal DVT were significantly higher than those in the anterior/posterior tibial vein or peroneal vein thrombosis and calf muscular venous thrombosis [54.9% (45/82), vs. 29.0% (9/31), 15.0% (9/60), both P < 0.05], the incidences of lower limb swelling in the proximal DVT were significantly higher than those in the calf muscular venous thrombosis [41.7% (15/63) vs. 15.0% (9/60), P < 0.05], there were no significant difference in the other clinical manifestations among the DVT groups. There was no significant difference in the incidence of VTE risk factors among the groups. Conclusions:The DVT of inpatients mostly occurred in the left lower limb, and the incidence of distal DVT was higher than that of proximal DVT. Mixed DVT and proximal DVT combined with pulmonary embolism mostly occurred in the main pulmonary artery, left or right pulmonary artery trunk, while distal DVT combined with pulmonary embolism mostly occurred in the pulmonary segmental artery. The levels of D-dimer in patients with lower extremity DVT combined with main pulmonary artery or left and right pulmonary artery trunk embolism were higher than those in patients with pulmonary lobe and segmental artery embolism. The incidence of lower extremity swelling in patients with mixed DVT and proximal DVT was higher than that in patients with distal DVT.
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Objective@#To evaluate the capability of magnetic resonance imaging 3D-sampling perfection with application optimize contrasts using different flip angle evolution (MRI 3D-SPACE) full-volume scanning sequence to detect lower extremity deep vein thrombosis (LEDVT), and to explore the characteristics of the images of LEDVT and surrounding soft tissue at different stages.@*Methods@#MRI 3D-SPACE full volume T1WI and T2WI scanning of lower limb were performed on 45 patients diagnosed of LEDVT via digital subtraction angiography (DSA) by Siemens Prisma 3T MRI scanner. 43 cases completed scanning. The location and quantity of vascular segment lesions were recorded, of which the diagnostic sensitivity, specificity and accuracy were calculated comparing to the gold standard of DSA results. The characteristics of magnetic resonance imaging signals of thrombus and thrombus surrounding soft tissue at different times were summarized.@*Results@#According to the location of thrombosis, there were 15 cases of central type, 17 cases of peripheral type and 11 cases of mixed type. In all imaging levels, 272 segments of embolic vessels were found in 3D-space T1WI and 261 segments in 3D-space T2WI. Compared with the DSA results, the sensitivity, specificity, and accuracy of the two groups in the diagnosis of deep venous thrombosis were: T1 WI: Common iliac vein 97.10%, 97.90%, 98.20%; External iliac vein 96.80%, 97.60%, 97.10%; Internal iliac vein 96.40%, 97.20%, 97.20%; Femoral vein 98.10%, 98.20%, 98.50%; Popliteal vein 94.40%, 93.50%, 93.70%; The anterior tibial vein is 94.30%, 88.50% and 90.40%. The posterior tibial vein is 93.40%, 85.20%, 85.30%. T2WI: Common iliac vein 97.10%, 97.90%, 97.10%; External iliac vein 96.50%, 96.20%, 96.00%; Internal iliac vein 96.20%, 96.60%, 96.20%; Femoral vein 98.10%, 98.20%, 98.50%; Popliteal vein 93.40%, 92.50%, 92.70%; The anterior tibial vein is 90.30%, 86.50% and 85.40%; Posterior tibial vein 89.40%, 84.20%, 83.30%. According to the onset time, 17 cases in the acute phase, the thrombus was equal or slightly higher and uneven signal in the two groups of sequences, the perivascular and muscle tissue gap signal increased; 21 cases in the subacute phase, the thrombus was high in both groups signal; 5 cases in the chronic phase, the thrombus showed equal or slightly lower signal in the two groups of sequences, the blood vessel wall was irregular, and the surrounding soft tissue was mild or no obvious edema.@*Conclusions@#MRI 3D-space sequence full volume scanning technology has high sensitivity, high specificity and high accuracy for the diagnosis of lower extremity deep vein thrombosis, and can reflect the characteristics of thrombus and soft tissue signal around thrombus in different periods. It has high application value for the early detection of thrombosis and the stage diagnosis of the course of disease.
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Objective@#To study the effect of warfarin individualized drug regimen based on gene detection on anticoagulation in patients with acute deep vein thrombosis (DVT).@*Methods@#From January 2016 to June 2017, 62 patients with DVT diagnosed for the first time in vascular surgery of the Affiliated Hospital of Jining Medical College were analyzed retrospectively, including 33 in the individualized group and 29 in the experience group. All patients were diagnosed by Color Doppler Ultrasound (CDUS). Gender, age, the results of the initial international standardized ratio (INR) measurement, the time from the first dose to the INR standard, and whether the INR exceeds the standard in the process of increasing the dose were collected.@*Results@#There was no significant difference in sex, age and initial INR between the two groups (P>0.05). The time of reaching the standard in the individualized group was significantly lower than that in the experience group [(13.8±6.8)d vs (17.6±7.5)d, P<0.05]; There was no significant difference in INR between the two groups (P=0.377).@*Conclusions@#For the patients with DVT for the first time, the individualized drug regimen of warfarin based on the guidance of gene detection can shorten the time of reaching the standard without increasing the risk of bleeding.
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Objective To evaluate the capability of magnetic resonance imaging 3D-sampling perfection with application optimize contrasts using different flip angle evolution (MRI 3D-SPACE) full-volume scanning sequence to detect lower extremity deep vein thrombosis (LEDVT),and to explore the characteristics of the images of LEDVT and surrounding soft tissue at different stages.Methods MRI 3D-SPACE full volume T1WI and T2WI scanning of lower limb were performed on 45 patients diagnosed of LEDVT via digital subtraction angiography (DSA) by Siemens Prisma 3T MRI scanner.43 cases completed scanning.The location and quantity of vascular segment lesions were recorded,of which the diagnostic sensitivity,specificity and accuracy were calculated comparing to the gold standard of DSA results.The characteristics of magnetic resonance imaging signals of thrombus and thrombus surrounding soft tissue at different times were summarized.Results According to the location of thrombosis,there were 15 cases of central type,17 cases of peripheral type and 11 cases of mixed type.In all imaging levels,272 segments of embolic vessels were found in 3D-space T1WI and 261 segments in 3D-space T2WI.Compared with the DSA results,the sensitivity,specificity,and accuracy of the two groups in the diagnosis of deep venous thrombosis were:T1 WI:Common iliac vein 97.10％,97.90％,98.20％;External iliac vein 96.80％,97.60％,97.10％;Internal iliac vein 96.40％,97.20％,97.20％;Femoral vein 98.10％,98.20％,98.50％;Popliteal vein 94.40％,93.50％,93.70％;The anterior tibial vein is 94.30％,88.50％ and 90.40％.The posterior tibial vein is 93.40％,85.20％,85.30％.T2WI:Common iliac vein 97.10％,97.90％,97.10％;External iliac vein 96.50％,96.20％,96.00％;Internal iliac vein 96.20％,96.60％,96.20％;Femoral vein 98.10％,98.20％,98.50％;Popliteal vein 93.40％,92.50％,92.70％;The anterior tibial vein is 90.30％,86.50％ and 85.40％;Posterior tibial vein 89.40％,84.20％,83.30％.According to the onset time,17 cases in the acute phase,the thrombus was equal or slightly higher and uneven signal in the two groups of sequences,the perivascular and muscle tissue gap signal increased;21 cases in the subacute phase,the thrombus was high in both groups signal;5 cases in the chronic phase,the thrombus showed equal or slightly lower signal in the two groups of sequences,the blood vessel wall was irregular,and the surrounding soft tissue was mild or no obvious edema.Conclusions MRI 3D-space sequence full volume scanning technology has high sensitivity,high specificity and high accuracy for the diagnosis of lower extremity deep vein thrombosis,and can reflect the characteristics of thrombus and soft tissue signal around thrombus in different periods.It has high application value for the early detection of thrombosis and the stage diagnosis of the course of disease.
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Objective To study the effect of warfarin individualized drug regimen based on gene detection on anticoagulation in patients with acute deep vein thrombosis (DVT).Methods From January 2016 to June 2017,62 patients with DVT diagnosed for the first time in vascular surgery of the Affiliated Hospital of Jining Medical College were analyzed retrospectively,including 33 in the individualized group and 29 in the experience group.All patients were diagnosed by Color Doppler Ultrasound (CDUS).Gender,age,the results of the initial international standardized ratio (INR) measurement,the time from the first dose to the INR standard,and whether the INR exceeds the standard in the process of increasing the dose were collected.Results There was no significant difference in sex,age and initial INR between the two groups (P ＞ 0.05).The time of reaching the standard in the individualized group was significantly lower than that in the experience group [(13.8 ± 6.8) d vs (17.6 ± 7.5) d,P ＜ 0.05];There was no significant difference in INR between the two groups (P ± 0.377).Conclusions For the patients with DVT for the first time,the individualized drug regimen of warfarin based on the guidance of gene detection can shorten the time of reaching the standard without increasing the risk of bleeding.
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Objective To evaluate the value of color Doppler ultrasonography combined with coagulation test in the diagnosis of postpartum thrombosis and the prediction of thrombosis in pregnant women.Methods Color Doppler ultrasonography and blood coagulation examination were performed at 1 weeks before and 1 weeks after delivery respectively.Two or more abnormalities in both examinations were defined as positive thrombus combined diagnosis,two ultrasound tests that showed " snowstorm" sign were cdefined aspositive ultrasonic diagnosis.Thrombus formation in 30d after delivery was followed up.Three-dimensional x2 test was used to compare the sensitivity and specificity of the combined diagnosis group and the ultrasonic diagnosis group.Results 238 cases were included in the study,including 76 positive cases and 162 negative cases in combined diagnosis group,103 positive cases and 135 negative cases in ultrasonic diagnosis group.At the end of the follow-up period,there were 28 cases (36.84％) of the deep venous thrombosis of the lower extremities occurred in the combined diagnosis positive group and 21 cases (20.39％) in ultrasound diagnosis positive group.Kaplan-Meier method was used to analyze the lower extremity deep vein thrombosis of the positive subjects in the two diagnostic methods.Log Rank showed that the difference between the two groups was statistically significant (x2 =5.952,P =0.015).The sensitivity and specificity of the combined diagnosis positive group were higher than those of ultrasound diagnosis positive group,the difference was statistically significant (90.32％ vs.67.74％;76.81％ vs.60.39％) (x2=4.00,x2=22.69,P＜0.05).Conclusion Color Doppler ultrasonography combined with blood coagulation function can be used to diagnose prethrombotic state in pregnant women,and have high sensitivity and specificity for predicting deep vein thrombosis of lower extremities in pregnant women.
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Objective To investigate the prevention effects of antithrombotic pressure pump combined with graduated compression stockings (GCS) on incidence of postoperative lower extremity deep venous thrombosis (LEDVT) in breast cancer patients. Methods A total of 363 cases of breast cancer patients after operation were divided into routine care group (124 cases) according to the method of random number table, pressure group (127 cases) and combined treatment group (112 cases). The routine care group received conventional LEDVT ankle pump exercises. The pressure group used GCS besides the routine intervention. The combined group received GCS and antithrombotic pressure pump besides the routine intervention. Then the levels of thrombosis markers, D-dimers,platelets, and incidences of LEDVT were examined in the three groups. Results Before operation, no significant differences between the levels of prothrombin time (PT), activated partial prothrombin time (APTT), thrombin time (TT), fibrinogen, plasma D-dimer and platelets (P>0.05). After operation, the levels of PT, APTT, TT, fibrinogen, plasma D-dimer and platelets in three groups were (10.22 ± 0.76) s, (27.24 ± 3.68) s, (14.60 ± 0.88) s, (2.94 ± 0.59) mg/L, (0.31 ± 0.21) mg/L, (288.48 ± 71.29) × 109/L, (10.73 ± 0.79) s, (27.35 ± 2.54) s, (14.71± 1.76) s, (4.12±1.09) mg/L, (0.46±0.38) mg/L, (284.26±70.98) ×109/L and (11.11±0.64) s、(28.52± 2.74) s, (14.33± 1.02) s, (4.42±1.20) mg/L, (0.35±0.33) mg/L, (258.79±62.35) ×109/L, respectively. There was significant difference among these groups (F=5.71-87.31, P<0.01). The differences on PT, APTT, fibrinogen and D-dimers between combined treatment group and routine care group were statistically significant (P<0.05). The differences on PT, fibrinogen and platelets between combined treatment group and pressure group were statistically significant (P<0.05). The differences on PT, APTT, fibrinogen and D-dimers between routine care group and pressure group were statistically significant (P<0.05). Through one months of follow-up, the incidence of LEDVT in routine care group, pressure group and combined treatment group were 12.10％(15/124),3.15％(4/127),0.89％(1/112), respectively. There was significant difference among these groups (χ2=16.279,P<0.01). Conclusions The application of antithrombotic pressure pump combined with GCS significantly improves the postoperative hypercoagulable states in breast cancer patients. The combined treatment reduces the incidence of LEDVT without bleeding risk. Therefore, antithrombotic pressure pump combined with GCS is recommended for clinical use in the postoperative breast cancer patients.
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Objective To observe the preventive effect of Taohong Siwu decoction on the formation of lower extremity deep vein thrombosis (DVT) in patients with cerebral hemorrhage.Methods Eighty patients with cerebral hemorrhage admitted to the Department of Neurosurgery in Huzhou First People's Hospital from November 2014 to January 2016 were enrolled, and they were divided into an observation group and a control group according to the difference in treatment methods, each group 40 cases. Both groups were given routine treatment and nursing care, the patients of observation group were additionally given Taohong Siwu decoction (composition:Radix Angelicae Sinensis (stir-fried with wine) 10 g,Radix Rehmanniae Preparata 10 g,Radix Paeoniae Alba10 g,Ligusticum Chuanxiong Hort 6 g,Semen Persicae 6 g,Carthami Flos 4 g), once a day for consecutive 2 weeks.Results The D-dimer level in the observation group was significantly lower than that in the control group (mg/L: 1.47±0.91 vs. 1.88±0.79,t = 1.991,P = 0.035); the incidence of DVT in the observation group was obviously lower than that in the control group [5.0% (2/40) vs. 20.0% (8/40), χ2 = 4.114,P = 0.043].Conclusion Taohong Siwu decoction can effectively reduce the incidence of DVT in patients with cerebral hemorrhage.
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Objective To discuss the efficacy and complications of using AngioJet rheolytic thrombectomy in treating acute lower extremity deep vein thrombosis (DVT).Methods The clinical data of 22 patients with acute lower extremity DVT,who were treated with AngioJet rheolytic thrombectomy during the period from February 2015 to August 2016,were retrospectively analyzed.The improvement of clinical symptoms and the thrombus clearance rate were calculated to evaluate the curative effect.The procedure-related complications were documented.Results The clinical symptoms were relieved immediately after operation in all 22 patients.The thigh circumference difference between the affected side and the healthy side decreased from preoperative (4.5±0.6) cm to postoperative (1.0±0.4) cm,the difference in change was statistically significant (P＜0.05).The mean used dose of urokinase was (0.18±0.03) million unit and the average duration of thrombolysis was (4.2±0.7) hours.Complete removal of DVT (＞90％) was achieved in 19 patients,most removal of DVT (50％-90％) in 2 patients,and partial removal of DVT (＜50％) in one patient.After treatment,6 patients developed transient hemoglobinuria,which was relieved after hydration with fluid infusion on the same day.No serious complications such as pulmonary embolism or hemorrhage occurred.Conclusion For the treatment of acute lower extremity DVT,AngioJet rheolytic thrombectomy is safe and effective with less complications.
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Objective To investigate the clinical efficacy and safety of low-dose aspirin in prevention of lower extremity deep venous thrombosis after cesarean section. Methods from January 2016 to March 2017 in our hospital obstetrics and Gynecology cesarean section in 374 cases as the research object, using the method of random number table according to the proportion of 1:1 were divided into control group and observation group, each group of the 187 cases, the control group after cesarean section treated with routine comprehensive preventive measures, the observation group in the control group received the low-dose aspirin treatment. Observation group 2 postpartum in January the incidence of deep venous thrombosis, postoperative 12 h, postoperative serum 7 d two D- dimer (D-D), fibrinogen (FIB), activated partial thromboplastin time (APTT), prothrombin time (PT) and platelet count (PLT) and blood rheology index, statistics of the 2 groups the incidence of bleeding complications. Results Deep venous thrombosis in the observation group was significantly lower than the control group (P<0.05); the 2 group after 5D-D and FIB and 12 h after operation were significantly decreased (P<0.05), and the observation group and the control group in the same period were significantly decreased (P<0.05); 2 groups were PT, APTT, PLT showed no significant difference compared with the preoperative, and the observation group and the control group in the same period. There was no statistically significant difference ; 2 group 7 d after operation and high blood viscosity, whole blood viscosity, whole blood low shear viscosity, plasma viscosity and postoperative 12 h compared were significantly decreased (P<0.05), and the observation group with the same period compared with the control group decreased significantly (P<0.05); postoperative 7 d erythrocyte deformation index and postoperative 12 h were significantly increased (P<0.05), and the observation group and the control group in the same period compared significantly increased (P<0.05); the incidence of bleeding complications was not statistically significant 2 after the operation of group. Conclusion Hypercoagulability of low-dose aspirin helps improve puerpera after cesarean section, reduce blood viscosity, reduce the incidence of venous thrombosis, does not increase the incidence of bleeding, clinical application of good safety, which is worthy of clinical application.
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Objective@#To explore clinical features of idiopathic hypereosinophilic syndrome combined with pulmonary embolism.@*Method@#A retrospective analysis of a patient with idiopathic hypereosinophilic syndrome and pulmonary embolism diagnosed and treated in the Respiratory Department of Shanghai Children′s Hospital in September 2016 was performed. A literature search was performed with"Eosinophils increased, thrombosis"as the Chinese keywords in Wanfang database and"idiopathic hypereosinophilic syndrome, deep vein thrombosis"as the English key words in PubMed database. The time interval was from April 1985 to March 2017.@*Result@#The patient was 11-year-old with fever and cough. Computed tomography angiography (CTA) showed pulmonary embolism, inferior vena cava thrombosis. Ultrasound examination of the left leg demonstrated venous thrombosis. Complete blood count showed eosinophilia and thrombocytopenia. Literature found 30 articles, including eighteen case reports, twelve reviews and other types of articles. A total of 23 cases were reported, only three were pediatric cases. According to the literature that eosinophilia can damage the vascular epithelium, leading to multiple arterial and venous thromboses, anticoagulation and glucocorticoid treatments are effective.@*Conclusion@#The diagnosis of idiopathic hypereosinophilic syndrome is complicated. It may cause multiple thromboses. Anticoagulation and glucocorticoids can reduce eosinophil count and decrease its toxins which can injure vascular endothelium. The effectiveness of preventative anticoagulant therapy is unclear and requires further clinical study.
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Objective To evaluate the possibility of deep vein thrombosis defluvium of lower limb using ultrasonography to provide important reference for the implantation and retrieve of retrievable inferior vena cave (IVC ) filters.Methods Sixty-four patients who were diagnosed as lower limb deep vein thrombosis using ultrasonography were enrolled.Fourteen patients with critical values were allocated to high risk group,50 patients without critical value to low risk group.All the patients underwent inferior vena cava filter operation.Of all these patients,ultrosonography were performed once again before IVC filters were retrieved.Seventeen patients with broken thrombosis were allocated to unstable group,47 patients with stable thrombosis to stable group.Relationships between conditions of thrombosis and ultrasonography results were analysed.The conditions of thrombosis were recorded.The rates of thrombosis defluvium were compared.Results In high risk group,10 patients (71 .43%)had thrombosis.In low risk group,8 patients (16%)had thrombosis.There were significant differences in the rates of thrombosis defluvium beteen the high risk group and low risk group(P <0.05).In unstable group,12 patients (70.59%)had thrombosis.In stable group,6 patients (12.77%) had thrombosis,there were significant differences in the rates of thrombosis defluvium between the unstable group and stable group (P < 0.05 ).Conclusions Ultrasonography can be used to evaluate the possibility of lower extremity deep vein thrombosis defluvium which will guide the pratice of the retrievable inferior vena cava filter.
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Objective To analyze the influence factors of lower extremities deep venous thrombosis after hip replacement,and provide guidance for perioperative prevention.Methods 52 cases of patients underwent total hip replacement were selected,who were given color doppler ultrasound examination for lower limb venous thrombosis after hip replacement.And analyzed risk factors of lower extremity deep vein thrombosis from patient's gender,age,blood lipid,D -dimer,complications and surgical index.Results During the 52 cases,16 cases were found with postopera-tive lower limb deep vein thrombosis (30.8%);Single factor analysis showed that patients with age ≥65 years,over-weight or obese (BMI≥25kg/m2 ),high triglycerides (TG ≥ 1.7mmol/L)and high D -dimer level (≥500μg/L), diabetes or high blood pressure,large blood transfusion combined with a greater incidence of postoperative deep vein thrombosis (P <0.05).Further multiple factors regression analysis showed that age ≥65 years,overweight or obesity, high triglycerides,high D -dimer,diabetes,large blood transfusions were independent risk factors of lower extremity deep vein thrombosis (OR =15.693,1.278,9.832,3.053,1.855,1.014,all P <0.05).Conclusion Patients with total hip replacement should be given preoperative vein thrombosis risk assessment,patients with age ≥65,overweight or obese,high triglycerides,D -dimer level,diabetes,large number of blood transfusions have higher risk of deep vein thrombosis,we should focus on perioperative monitoring,application of low molecular heparin,lower limb vein pump, etc.early postoperative lower limb rehabilitation exercise,to reduce the occurrence of deep vein thrombosis.