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A Prospective Survey of the Incidence of Venous Thromboembolism in a Limited Capacity of Patients Undergoing Major Orthopaedic Surgery

Author: SunYang
Tutor: WangJinCheng
School: Jilin University
Course: Surgery
Keywords: Major Orthopaedic Surgery Venous ThromboEmbolism Deep VenousThrombosis Preventive Measure
CLC: R687.4
Type: Master's thesis
Year: 2013
Downloads: 40
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Abstract


Objective: To investigate the incidence of venous thromboembolism(VTE) in patients undergoing major orthopaedic surgery in China-JapanUnion Hospital of Jilin University, and to investigate the protective effect ofpreventive measures against the formation of venous thromboembolism.Methods: A prospective survey contains the clinical data of China-JapanUnion Hospital of Jilin University consisted of patients with major orthopedicsurgery from September2012to March2013for35cases, consisting of19male and16female cases, aged35to93years, the average (63.1土9.9) years.Among them,23cases undergoing total hip arthroplasty, total knee arthroplastysurgery in8cases, and hip fracture surgery in4cases; All patients taking thedrug preventive measures, yet none of them taking the physical preventionmeasures. Home-made case report form to collect relevant information,including basic information, the main admission diagnosis, pre-operativemerged with deep vein thrombosis-related diseases, preoperative bloodtriglyceride levels, operation name, stay in bed for the duration of thepreventive measures of VTE formation and lower extremity deep venous ultrasound results. All clinical cases were based on the assignment of therelevant projects to the count data, using SPSS statistical analysis of the impactof preventive measures on the incidence of DVT. In addition, theepidemiological data of DVT formation in2005seven countries in Asia and19centers in major orthopedic surgery were compared to analyze the protectiveeffect of the difference between the incidence of DVT and preventive measures,using two-sided test, with p<0.05as meaningful, and calculate odds ratio.Results:14cases with suspected symptomatic postoperative VTE, then3cases(all DVT) diagnosed, the rate was8.57%and the false positive rate is78.6%, all through deep venous color Doppler ultrasound examination, lowerthan the domestic and international coverage rate of exposure groups, OR is0.139. Age, diabetes, infection, active bleeding, triglyceride level, ambulatoryduration of DVT, no significantly presented in promoting preventive measuresbecause of lack of samples. Lower than the incidence reported in the literatureof seven countries in Asia and19centers in major orthopedic surgery afterDVT,OR is0.139.Conclusion: Symptomatic DVT incidence in patients undergoing majororthopaedic surgery in China-Japan Union Hospital of Jilin University was8.57%,lower than the domestic and international coverage of exposuregroups,p<0.001,OR is0.139. The use of preventive measures do measure,besides, the high false positive rate indicates the importance of physicalexaminations and differential diagnosis. Age, diabetes, infection, activebleeding, triglyceride levels, and bed rest duration may promote the occurrence of DVT, but in this study did not reflect its role, due to the lack of samples.

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CLC: > Medicine, health > Surgery > Orthopaedic Surgery ( movement system diseases,orthopedic surgery ) > Orthopedic surgery and surgery > Joint Surgery
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