Clinical study on prevention of peroperative period deep vein thrombosis after total hip replacement / 中国医师进修杂志

ABSTRACT

Objective To explore the treatment measures of peroperative period deep vein thrombosis (DVT) after total hip replacement.Methods The clinical data of 300 patients who were treated by total hip replacement were analyzed retrospectively.All patients were given conventional detection of coagulation status.The level of D-dimer (D-D) was detected after operation for 1,3,5 d.The patients who suspected with DVT were checked lower limb by color Doppler ultrasonography.If the diagnosis was not clear,the venography was took.All patients were treated with physical therapy and anticoagulation therapy.Results Twenty patients (30 limbs) were diagnosed with DVT before operation,7 patients were central type,13 patients were peripheral type.All patients underwent preoperative anticoagulation,the level of D-D in non-DVT patients was decreased.The level of D-D in DVT patients in the first and third day kept at high level and were 6500,6800 μ g/L.After operation,40 patients were diagnosed with DVT.The peripheral type DVT patients were treated with continued anticoagulation for 6 months,the central type or mixed type DVT patients were treated by temporary vena cava filter,all patients had no severe complications during peroperative period.Conclusions The operation of total hip replacement need sufficient assessment and monitoring during peroperative period.Postoperative early functional exercise and anticoagulation therapy may be given to prevent DVT.