Study On Deep Vein Thrombosis Prophylaxis Of Ankylosing Spondylitis Patients After Total Hip Arthroplasty

ObjectiveAnkylosing spondylitis is an inflammatory rheumatic disease that will cause severe dysfunction of the hip. Total hip replacement is a kind of elective surgery to improve the patients’quality of life. The surgery those who were already showing the hip joint stiffness. The patients will relieve symptoms of the hip joint stiffness and improving walking dysfunction with the hip motion range increased. Deep vein thrombosis is often thought of serious complications of artificial joint replacement. According to the venous thromboembolism disease prevention guidelines published by American academy of orthopedic surgeons, the American college of chest physicians, and the Chinese medical association, patients with different diseases were treated with a set of recommendations. This study aims to compare the different deep vein thrombosis prophylaxis of ankylosing spondylitis after total hip replacement and provide personalized program for different diseases and patients.PART IMaterials and MethodsWe performed a retrospectively study and accessed registration database of patients underwent total hip arthroplasty from January 2009 to January 2011 and from January 2013 to January 2015in our hospital. We divided the patients into two groups with diagnosis. One group was femoral head necrosis (FHN) group and the other was ankylosing spondylitis (AS) group. Comparison between the value between two groups of baseline demographic data, the incidence of VTE, D-dimer, intraoperative blood loss, Operatively-estimated blood loss and hospital blood replacement were analyzed.ResultsThe incidence of DVT in AS group was lower than that of femoral head necrosis (FHN) group, although no significant difference was detected. The patients of AS group were much younger (P<0.0001) and lower BMI (P=0.0036) compared with those of FHN group. AS patients had lower hypertension rate(P<0.0001) and diabetes rate(P= 0.0385). The values of APTT, PT, and INR in AS patients were higher than those in FHN patients (all<0.0001). Operatively-estimated blood loss and hospital blood replacement of AS group were higher than the FHN group.Conclusion1. AS patients potentially had a lower incidence of DVT compared with FHN patients.2. Operatively-estimated blood loss and hospital blood replacement of AS group were higher than the FHN group in using the same deep vein thrombosis prophylaxis.PART ⅡMaterials and MethodsWe performed a retrospectively study and accessed registration database of patients underwent total hip arthroplasty from January 2009 to January 2011 in our hospital. We divided the patients into three groups with the dose of anticoagulant. One group was the normal group followed by the guideline and the other two groups was half dose of anticoagulant group and no anticoagulant group. Comparison between the value between three groups of baseline demographic data, the incidence of VTE, D-dimer, intraoperative blood loss, Operatively-estimated blood loss and hospital blood replacement were analyzed.ResultsThe incidence of DVT in three groups showed no significant difference. Hospital blood replacement of the two personalized groups were lower than the normal group(P<0.0001). The incidence of DVT between the two groups showed no significant difference.ConclusionHospital blood replacement of the two personalized groups were lower than the normal group(P<0.0001). The incidence of DVT in three groups showed no significant...