中国现代医学杂志2025，Vol.35Issue(5)：12-17,6.DOI:10.3969/j.issn.1005-8982.2025.05.003
股骨头坏死患者外侧入路初次全髋关节置换术后深静脉血栓形成的危险因素分析
Analysis of risk factors for deep vein thrombosis after primary total hip arthroplasty via lateral approach in patients with osteonecrosis of the femoral head
摘要
Abstract
Objective To analyze the risk factors for deep vein thrombosis(DVT)after primary total hip arthroplasty(THA)via a lateral approach in patients with osteonecrosis of the femoral head(ONFH).Methods Clinical data of 117 ONFH patients who underwent primary THA via lateral approach at Xi'an International Medical Center Hospital from September 2020 to February 2023 were retrospectively analyzed.Based on postoperative DVT occurrence,patients were divided into a DVT group(n=48)and a non-DVT group(n=69).Clinical characteristics were compared between groups.Multivariate logistic regression analysis was performed to identify DVT risk factors.A risk prediction model was constructed,and its accuracy was evaluated using receiver operating characteristic(ROC)curves.Model validation was conducted via the Bootstrap resampling method with 1,000 repetitions.Results The DVT group had significantly higher proportions of patients aged ≥ 65 years(P＜0.05),history of thrombosis(P＜0.05),use of local anesthesia(P＜0.05),triglycerides ≥ 1.7 mmol/L(P＜0.05),and cholesterol ≥ 4 mmol/L(P＜0.05)compared to the non-DVT group.Multivariate analysis identified independent risk factors:age ≥ 65 years[OR=4.345(95％CI:1.341,14.077)],history of thrombosis[OR=3.541(95％CI:1.210,10.358)],anesthesia type[OR=3.438(95％CI:1.147,10.303)],triglycerides ≥ 1.7 mmol/L[OR=11.176(95％CI:3.656,34.162)],and cholesterol ≥ 4 mmol/L[OR=6.909(95％CI:2.207,21.631)](all P＜0.05).The nomogram model demonstrated a sensitivity of 87.50％(95％CI:0.748,0.953),specificity of 79.7％(95％CI:0.683,0.884),and good calibration(P＞0.05).Conclusion Age,history of thrombosis,anesthesia type,triglycerides,and cholesterol are critical risk factors for DVT after lateral approach THA in ONFH patients.The established prediction model shows clinical utility for risk stratification.关键词
全髋关节置换术/股骨头坏死/外侧入路/深静脉血栓/危险因素Key words
total hip arthroplasty/osteonecrosis of the femoral head/lateral approach/deep vein thrombosis/risk factors分类
医药卫生引用本文复制引用
孙鹏霄,方庆,段永宏,朱庆生..股骨头坏死患者外侧入路初次全髋关节置换术后深静脉血栓形成的危险因素分析[J].中国现代医学杂志,2025,35(5):12-17,6.基金项目
陕西省重点研发计划项目(No:2021SF-165) （No:2021SF-165）
