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目的观察糖尿病是否会增加人工全膝关节置换(TKA)术后患者下肢深静脉血栓(DVT)的发生率。方法实验纳入2011年6月至2013年2月间,在本组行TKA手术的患者。根据患者是否合并有糖尿病,将其分别纳入糖尿病组与非糖尿病组。在术后第3、14天,通过彩色多普勒超声检查,诊断患者是否发生下肢DVT。比较两组间下肢DVT的发生率是否有差异,并通过逻辑回归分析糖尿病与下肢DVT的关系。结果共358例患者被纳入实验。术后14 d内,糖尿病组有52例患者发生下肢DVT,非糖尿病组有146例患者发生了下肢DVT(P<0.05)。糖尿病组有16例患者的血栓发生在手术对侧的肢体,非糖尿病组有50例(P>0.05)。通过Logistic回归分析,糖尿病患者术后发生下肢DVT的风险是非糖尿病患者的2.71倍[95%CI(1.183~6.212),P>0.05]。两组间年龄、性别、高血压患病率、BMI、手术时间、术中出血量、止血带使用时间均无统计学差异。结论虽然目前仍然存在争议,但在本实验中,糖尿病患者TKA术后下肢DVT的发生率高于非糖尿病患者。
Objective To investigate whether diabetes mellitus can increase the incidence of deep venous thrombosis (DVT) in patients undergoing total knee arthroplasty (TKA). Methods The experiment included patients who underwent TKA surgery in our department from June 2011 to February 2013. According to whether patients with diabetes mellitus, they were included in the diabetic group and non-diabetic group. On day 3 and day 14 after surgery, color Doppler ultrasonography was used to diagnose whether DVT occurred in the lower limbs. The incidence of DVT was compared between the two groups. Logistic regression analysis was used to analyze the relationship between diabetes and lower extremity DVT. A total of 358 patients were included in the experiment. In the 14 days after operation, DVT of lower extremity occurred in 52 patients with diabetes mellitus. DVT of lower extremity occurred in 146 patients without diabetes (P <0.05). Sixteen patients with diabetes mellitus had thromboembolism in the contralateral limbs and 50 in non-diabetic patients (P> 0.05). Logistic regression analysis showed that the risk of postoperative DVT of lower extremity in diabetic patients was 2.71 times higher than that of non-diabetic patients [95% CI (1.183 ~ 6.212), P> 0.05]. There were no significant differences in age, gender, prevalence of hypertension, BMI, operation time, intraoperative blood loss and tourniquet time between the two groups. Conclusions Although there is still controversy, in this experiment, the incidence of DVT in lower extremities after TKA in diabetic patients was higher than in non-diabetic patients.