| SuperPATH技术对全髋关节置换围手术期术后下肢深静脉血栓形成的影响 |
| The effect of SuperPATH total hip arthroplasty on postoperative deep vein thrombosis in the lower limbs during the perioperative period |
| 投稿时间：2025-11-25 |
| DOI：10.3969/j.issn.1672-5972.2026.04.003 |
| 中文关键词: SuperPATH 全髋关节置换 凝血功能 下肢静脉血流动力学 下肢深静脉血栓形成 |
| 英文关键词:SuperPATH Total hip arthroplasty Coagulation function Lower limb venous hemodynamics Lower extremities deep vein thrombosis |
| 基金项目:玉林市科学研究与技术开发计划项目（玉市科202235011） |
| 作者 | 单位 | 邮编 | | 罗善超* | 玉林市中西医结合骨科医院髋关节三科,广西 玉林,537000 | 537000 | | 赖英静 | 玉林市中西医结合骨科医院髋关节三科,广西 玉林,537000 | 537000 | | 钟武 | 玉林市中西医结合骨科医院髋关节三科,广西 玉林,537000 | 537000 | | 马惠 | 玉林市中西医结合骨科医院髋关节三科,广西 玉林,537000 | 537000 | | 杨芸 | 玉林市中西医结合骨科医院髋关节三科,广西 玉林,537000 | 537000 | | 苏先婵 | 玉林市中西医结合骨科医院髋关节三科,广西 玉林,537000 | 537000 | | 唐继仁* | 玉林市中西医结合骨科医院髋关节三科,广西 玉林,537000 | 537000 |
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| 中文摘要: |
| 目的 探讨SuperPATH技术对全髋关节置换（total hip arthroplasty, THA）围手术期术后下肢深静脉血栓（deep vein thrombosis, DVT）形成的影响。方法 将2022年7月至2024年4月玉林市中西医结合骨科医院行单侧人工全髋关节置换并符合选择标准的189例患者纳入研究。根据手术入路不同分为观察组（SuperPATH入路，n=90）和对照组（常规后外侧入路，n=99），两组术后均应用低分子肝素抗凝治疗。比较两组患者围手术期术后1、7和14 d的凝血功能指标，包括活化部分凝血活酶时间（APTT）、凝血酶原时间（PT）、D-二聚体（D-D）、血小板计数（PLT），以及下肢静脉血流动力学指标（平均血流速度、血流峰流速、平均血流量）和下肢DVT形成的发生率。结果 ①与对照组比较，观察组患者术后1 d的APTT缩短，差异有统计学意义（P＜0.05），术后7和14 d的APTT也缩短，但是差异无统计学意义（P＞0.05）；与对照组比较，观察组患者术后1 d的PT缩短，差异有统计学意义（P＜0.05），术后7 d和14 d的PT也缩短，但是差异无统计学意义（P＞0.05）；观察组患者术后1、7和14 d的D-D和PLT均较对照组降低，差异均有统计学意义（P＜0.05）。②观察组患者术后1、7和14 d的股静脉平均血流速度、血流峰流速、平均血流量均较对照组升高，差异有统计学意义（P＜0.05）。③观察组患者术后1、7、14 d的下肢DVT形成的发生率为11.11%（10/90）、低于常规后外侧入路对照组的29.29%（29/99），差异有统计学意义（P＜0.05）。④与对照组比较，观察组患者术后1、7、14 d的VAS评分均降低，差异均有统计学意义（P＜0.05）。⑤与对照组比较，观察组患者术后下地负重开始时间较早，差异有统计学意义（P＜0.05）。⑥观察组与对照组的手术时间比较，差异无统计学意义（P＞0.05）。结论 与常规后外侧入路比较，SuperPATH入路THA有利于改善患者围手术期术后的凝血功能和下肢静脉血流动力学指标，而且降低围手术期术后的VAS评分及有利于术后早期下地负重，从而减少患者围手术期术后下肢DVT形成的发生。 |
| 英文摘要: |
| Objective To investigate the effect of SuperPATH total hip arthroplasty (THA) on the formation of deep vein thrombosis (DVT) in the lower limbs during the perioperative period after surgery.Methods All 189 patients who underwent unilateral total hip arthroplasty at Yulin Orthopedic Hospital of Integrated Chinese and Western Medicine from July 2022 to April 2024 and met the selection criteria were included in the study. According to different surgical approaches, the patients were divided into the observation group (SuperPATH approach, n=90) and the control group (conventional posterior lateral approach, n=99), and the both groups were treated with low molecular weight heparin anticoagulation therapy after surgery. Comparing the coagulation function [activated partial thromboplastin time (APTT), prothrombin time (PT), D-dimer (D-D), platelet count (PLT)] and lower limb venous hemodynamic indicators (mean blood flow velocity, peak blood flow velocity, mean blood flow) and incidence of lower limb DVT formation between the two groups on postoperative days 1, 7, and 14.Results ①Compared with the control group, the APTT of patients in the observation group was shortened on postoperative day 1, with a statistically significant difference (P<0.05); APTT was also shortened on days 7 and 14, but the difference was not statistically significant(P>0.05). Compared with the control group, the PT of the observation group was shortened on postoperative day 1, and the difference was statistically significant (P<0.05). The PT was also shortened on postoperative days 7 and 14, but the difference was not statistically significant (P>0.05). The D-D and PLT of the observation group were significantly lower than those of the control group on postoperative days 1, 7, and 14 (P<0.05). ② The average blood flow velocity, peak blood flow velocity, and average blood flow of the femoral vein in the Observation group were significantly higher than those in the control group on postoperative days 1, 7, and 14 (P<0.05). ③ The incidence of lower limb DVT formation in the observation group was 11.11% (10/90) on postoperative days 1, 7, and 14, which was lower than the 29.29% (29/99) in the conventional posterior lateral approach control group, and the difference was statistically significant (P<0.05). ④ Compared with the control group, the VAS scores of patients in the observation group decreased significantly on postoperative days 1, 7, and 14 (P<0.05). ⑤ Compared with the control group, patients in the observation group began weight-bearing earlier after surgery, with a statistically significant difference (P<0.05). ⑥ There was no statistically significant difference in operative time between the observation group and the control group (P>0.05).Conclusion Compared with the conventional posterior lateral approach, the SuperPATH approach of THA is beneficial for improving the coagulation function and lower limb venous hemodynamic indicators of patients during the postoperative perioperative period, and reducing the VAS score during the postoperative perioperative period and conducive to early postoperative weight-bearing, thereby reducing the occurrence of lower limb DVT formation in patients during the postoperative perioperative period. |
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