Prediction of deep venous thrombosis in lower extremities after total knee arthroplasty by preoperative and postoperative platelet changes / 国际外科学杂志

ABSTRACT

Objective To explore the predictive significance of platelet changes on deep venous thrombosis of the lower limbs after total knee replacement,and to guide the early clinical prediction and prevent the occurrence of thrombotic events.Methods A retrospective study was conducted of the 50 patients who had been treated by total knee arthroplasty for degenerative knee osteoarthropathy from January 2016 to June 2018 in the Department of Orthopedics and Traumaology,Xi'an Jiangtong University Medical College Red Cross Hospital.There were 10 males and 40 females,aged from 47 to 80 years (average age 65.1 years).According to the results of B ultrasound examination of the lower extremities,the patients were divided into the non embolic group (24 cases) and the embolic group (26 cases).The platelet counts and hemoglobin levels of the two groups were recorded before and after operation,and their respective differences were calculated.The difference of hemoglobin difference between the two groups was analyzed.At the same time,the difference of platelet count and total knee joint were examined.Whether the deep venous thrombosis of the lower extremity after replacement was statistically significant.If there was no statistical difference in the difference in hemoglobin between the two groups,and the difference in platelet count was statistically significant,the ROC curve was made to determine the optimal screening point.If obeying the normal distribution and the homogeneity of the variance,an independent sample t test was performed on the platelet count difference and the hemoglobin amount difference between the two groups,and the dose data in accordance with the normal distribution was expressed as (Mean ±SD).Results The difference of platelet count was (30.4 ± 14.8) ×109/L in thrombosis group and (53.5 ± 15.2) × 109/L in thrombosis group.The difference of platelet count between the two groups had statistical significance (P ＜ 0.001).The best screening point of platelet count difference was 34.0 × 109/L.The difference of hemoglobin count between thrombosis group and thrombosis group was (20.8 ± 9.3) g/L and (24.0 ± 10.7) g/L,there was no significant difference in hemoglobin between the two groups (P ＞ 0.05).Conclusions Preoperative and postoperative platelet count difference can effectively predict the incidence of lower extremity deep venous thrombosis after total knee arthroplasty.When the platelet count difference before surgery ≥34.0 × 109/L,early prevention of deep venous thrombosis should be avoided.The formation of the occurrence.