多重血栓预防方案在髋关节置换中应用的相关研究
摘要
目的：
1：通过分析本院髋关节置换病人血栓的发生率。重点关注使用抗凝方案和未使用抗凝方案之间发生率的对比。根据血栓发生病人通过多元回归分析来确定髋关节置换病人血栓发生的危险因素。
2：分析HSS医院多重血栓预防方案在全髋关节置换病人中的应用,确定该方案的有效性和安全性。
3：根据第一部分的危险因素分析、HSS医院的多重预防方案及本院的实际情况制定本院的多重血栓预防方案运用于髋关节置换的病人,并与国内标准的血栓预防方案进行对比。确定该预防方案的有效性和安全性。
4：通过髋关节置换术后发生血栓与未发生血栓病人之间血清炎性因子(C反应蛋白,肿瘤坏死因子,巨噬细胞炎性蛋白1α)对比,确定血清炎性因子与髋关节置换术后发生血栓之间的关系。
方法：
第一部分：髋关节置换术后的血栓发生率及髋关节置换术后引起血栓性疾病相关因素多元回归分析
髋关节置换术后的血栓性疾病的发生率
骨科行全髋或人工股骨头关节置换的病人共298例,从2007年1月到2010年1月。其中男性142例占病人总数47.7%,女性为156例,占病人总数的52.3%。此组病人平均年龄68(28-93),术前诊断：股骨颈骨折(Gardon三型或四型)占36.9%,骨性骨性关节炎(OA)占28.4%,股骨头坏死26.5%,内风湿性关节炎5%,髋关节发育不良3.5%,其他诊断占1.7%。术后使用下肢气压泵和低分子肝素作为血栓预防方案。
当临床上怀疑有DVT时,使用彩色Doppler或静脉造影进行检查。怀疑有PE时,使用肺血管造影检查。如果确诊为深静脉血栓,给予低分子肝素治疗。远端的DVT治疗六周,近端的DVT治疗3个月。确诊为PE采用肝素治疗3-6个月。所有的病人随访至少3个月,没有一个病人失随访。
髋关节置换术后引起血栓性疾病相关因素多元回归分析
临床资料
选取我院骨科行全髋或人工股骨头关节置换的病人共874例,从2004年1月到2010年1月。其中男性365例占病人总数41.7%,女性为509例,占病人总数的58.3%。此组病人平均年龄66(30-94),排除骨科手术原因以外引起的静脉血栓形成。其中诊断为血栓性疾病的304例。其中所有病例中采用血栓预防的为298例,占总病例数34%,发生血栓的病例数为18例,发生率为6.7%；未使用血栓预防的为576例,占总病例数的66%,发生血栓病例为286例,发生率为32.7%。
统计学方法
应用非条件Logistic回归模型进行单因素和多因素分析非条件Logistic回归分析。治疗所得资料运用SPSS17.0软件进行分析,计量资料采用均数±标准差(x±S)表示采用t检验。
第二部分HSS医院髋关节置换病人危险因素多元回归分析及多重预防方案的应用
HSS医院多重预防组病人：在纽约特种外科医院的病人共993例,其中男性473例,女性529例,从2006年1月到2010年8月在HSS行全髋关节置换手术。排除了患有血小板减少症、有出血体质以及不能行硬膜外麻醉的病人。此组病人平均年龄64Y(20从96),47.2%为男性,52.8%为女性。术前诊断：91.9%为骨性关节炎(OA),2.3%为股骨头坏死,2.1%为髋关节发育不良,1.9%为内风湿性关节炎,1.7%为其它诊断。同时对术前存在的疾病进行统计,并根据美国麻醉医师协会评分(ASA)对病人进行分级。
手术由两位医生完成(EAS,TPS),采用硬膜外低压麻醉(平均动脉压维持在45-55mmHg).手术采用后外侧切口,尽量减少股静脉扭曲的时间,反复的冲洗和吸引出股骨髓腔内容物。当处理髋臼侧的时候,下肢处于中立位置。处理股骨侧髓腔之前2-3分钟,静脉给予肝素(10-15U/kg)。此组病人平均手术时间(35min-268min),平均失血量183ml(50ml-1400ml).
术后病人一到复苏室就给与周期性加压装置,穿戴超膝的弹力袜,立即进行主动的背伸和跖屈踝关节活动,术后早期下床活动,一般为术后1-2天。术后当晚根据术前患血栓性疾病风险评估给予抗凝药物。对于风险较低的给予阿司匹林；对于术前评估患VTE风险高的病人和不能耐受阿司匹林的给予华法林,同时定期监测凝血功能,保持1NR在1.8-2.0之间。抗凝药物使用4-6周。
当病人在临床上怀疑有DVT时,使用彩色Doppler或磁共振造影进行检查；临床上怀疑PE时,使用肺血管造影扫描或螺旋CT检查。深静脉血栓根据所发生的部位分为近端(血栓在骨盆、股骨和胭血管内),远端(血栓在小腿的血管内)。有症状的PE使用肺扫描。如果确诊为深静脉血栓,给予华法林治疗。远端的DVT治疗六周,近端的DVT治疗3个月。确诊为PE采用肝素治疗3-6个月。
所有的病人随访至少3个月,没有一个病人失随访。
HSS医院髋关节置换病人危险因素多元回归分析
收集从2006年1月年到2010年8月在HSS医院行全髋关节置换术病人993例,.其中男469例,女524例。排除标准、有出血体质以及不能行硬膜外麻醉的病人。此组病人平均年龄64(20-96)),,91.3%为骨性关节炎(OA),2.3%为股骨头坏死,2.1%为髋关节发育不良,1.9%为内风湿性关节炎,1.7%为其它诊断.根据上面的分析结果进行血栓危险因素多元回归分析。
2.1统计学方法
应用非条件Logistic回归模型进行单因素和多因素分析非条件Logistic回归分析。治疗所得资料运用SPSS17.0软件进行分析,计量资料采用均数±标准差(x±S)表示采用t检验。
在SPSS17.0软件中以血栓发生(DVT和PE)为因变量；性别、年龄、体重指数、既往史、麻醉、手术时间、术前献血、血栓药物为自变量,进行Logistic多因素回归分析。P值以0.05为界,P>0.05表示差异无显著性意义,P<0.05表示差异有显著性意义。
第三部分多重血栓预防方案在我院的应用
本院多重干预组：参考HSS的多重预防方案、AAOS的预防方案以及2009年《骨科大手术静脉血栓栓塞症预防指南》与本地区所研究的血栓性发病因素特点以及本院的实际情况进行多重干预措施的制定。
术前：术前及教育病人主动背伸和跖屈踝关节,锻炼股四头肌。
术中：硬膜外麻醉；股骨侧处理和下肢位置选择,尽量降低髋关节处于屈曲位的时间；
术后：周期性充气加压装置应用；术后早期活动强有力的背伸和跖屈踝关节；术后抗凝药物采用阿司匹林。使用6-8周。
周期性充气加压装置应用：手术结束返回病房后即刻开始,间隔6h使用1次,每次使用时间1h,连续使用7d。
标准组：根据2009年《骨科大手术静脉血栓栓塞症预防指南》制定。
术中：麻醉方式由麻醉师制定；
术后：周期性加压装置的运用和踝关节主动运动；术后使用抗凝血药物：低分子肝素；
2010年10月-2012年8月在我科行髋关节置换病人共120例病人,其中男性50例,女性70例.随机分为两组。第一组为多重方案预防组,此组病人共58例,其中男性20例,女性38例,平均年龄69.06±11.42岁。第二组为标准组,此组病人共62例,其中男性30例,女性32例,平均年龄72.80±6.45岁。采用的两组病例年龄、性别,原发病及治疗术式均无显著性。
统计学方法。采用SPSS17.0统计软件,率的比较采用检验,P<0.05为差异有统计学意义。
第四部分髋关节置换后血清炎性因子表达与深静脉血栓形成的相关性研究
一般资料：本院2010年10月-2012年8月住院髋关节置换术后病例12例。均经彩色超声多普勒确立诊断为下肢深静脉栓塞。其中,男性4例,女性8例,年龄36-80岁,平均年龄64.6岁。对照组髋关节置换术后无血栓形成20例,其中男8例,女12例,年龄24-74岁,平均48.87岁。2组患者一般资料差异无统计学意义。
对下肢DVT对照组,采集晨起空腹肘静脉血5ml以109mmo1/L枸橼酸钠抗凝,迅速转移到中心实验室(时间不超过40分钟,以避免蛋白质的变性和降解)。在中心实验室内采用高速离心机进行离心,以去除细胞和杂质。剩余的存入-80℃的深低温冰箱内保存,等待酶联免疫分析检测,此过程必须在一小时内完成,避免蛋白变性和降解.C反应蛋白,肿瘤坏死因子及巨噬细胞炎性蛋白-1α酶联免疫分析采用SPSS17.0分析软件进行统计处理,实验数据以x±s表示,行t检验分析,P<0.05为差异有显著性意义,P<0.01为差异有非常显著性意义。
结果
第一部分：髋关节置换术后的血栓发生率及髋关节置换术后引起血栓性疾病相关因素多元回归分析髋关节置换术后血栓的发生率
病例共有298例,其中发生了血栓性疾病18例。占病人总数的6.7%、、其中16例为DVT,占病例总数的5.3%,其中2例为PE,占病例总数的0.67%。髋关节置换术后引起血栓性疾病相关因素多远回归分析危险因素多元回归分析：结果显示：高血压、高血脂,PE史,DVT史,恶性肿瘤放或化疗以及手术时间与THA术后VTE的发生有相关性。
第二部分HSS多重方案预防方案的应用
术前的平均HCT为38.6%,出院时平均为32.0%。术前的平均HB为13.2mg/dl,出院的平均血红蛋白为10.9mg/dl。
输血统计：共210个患者没有输血,占总数的21.1%。共783个病人接受了输血,占病人总数的78.9%；其中只输了自体血的690个,占病人总数的69.4%,占输血总人数的88.1%；,只输异体血44个,占病人总数的4.4%,占输血总人数的5.6%,两者都输的49个,占病人总数的4.9%,占输血总人数的6.2%。自体血的平均输血量为单位1.09(1-3；SD,0.3),异体血平均输血量为1.25单位(1-4；SD,0.53),。接受异体血病人中,34个接受1个单位,8个接受了2个单位,2个接受了3个单位。
本组病人共有13人发生血栓性疾病,占病人总数的1.3%。所有血栓病人中确诊为DVT的有8例,发生率为0.8%。其中彩超诊断的个6,磁共振造影诊断2个。DVT位于近端的有4个,其中0个在髂静脉,2个在股静脉,2个在胭静脉,0个髂静脉和股静脉都有,0个股静脉和胭静脉都有。DVT位于远端4个。在这些DVT病人中同侧6个,对侧2个,双侧0个。所有血栓病人中有症状并且诊断为PE的有5个,发生率为0.5%。其中肺扫描诊断4个,螺旋CT诊断1个。没有一个为致命性的PE。8个病人在术后一周确诊(术后1-7天),5个在术后第二周,0个在术后6周。
在所有13个诊断为血栓性疾病的病人中,10个术前评估有临床易感因素。接受阿司匹林的病人中7例发生VTE,占接受阿司匹林治疗患者的0.9%,其中下肢深静脉血栓4例,有症状的肺栓塞3例；接受华法林的病人中6个发生VTE,占接受华法林治疗患者的2%,其中下肢深静脉血栓5,有症状肺栓塞1例。
两组病人VTE发生率比较
多重预防方案组VTE发生率与本院298例髋关节置换术后使用抗凝方案的VTE发生率相比之间有显著性差异(1.3%对6.7%,P=0.008)
危险因素多元回归分析：
结果显示：高血压,PE史,DVT史,手术时间,恶性肿瘤或化疗于THA术后VTE的发生有相关性。
第三部分多重血栓预防方案在我院的应用
多重预防组：平均手术时间92.73±10.47min,平均手术出血量280.48±74.17,有5例发生了下肢深静脉血栓,发生率为4.16%,无一例肺栓塞。
标准组：：平均手术时间87.85±15.59min,平均手术出血量320.00±56.65ml,有7例发生了下肢深静脉血栓,发生率为5.83%,无一例肺栓塞。多重预防组于标准组比较出血量和手术时间之间有无差异性,P>0.05,血栓的发生率没有差异性,P=0.207。抗凝费用多重预防组明显低于标准组(P<0.001)
第四部分髋关节置换后血清炎性因子表达与深静脉血栓形成的相关性研究
结果：本院2010年10月-2012年8月髋关节置换病人病例12例,均经彩色多普勒确立诊断为下肢深静脉栓塞。其中,男性4例,女性8例,年龄36-80岁,平均年龄64.6岁。没有发生血栓的髋关节置换病人18例,其中男8例,女10例,年龄24-74岁,平均48.87岁。髋关节置换均由同一组骨科医师进行。30例患者中,采用气管插管全身麻醉20例,硬膜外麻醉下10例,均经髋关节外侧入路,置换方法及置换后处理均相同；5例采用骨水泥骨定,25例采用非骨水泥固定。酶联免疫结果显示两组病人血清C-反应蛋白、肿瘤坏死因子-α、巨噬细胞炎性蛋白-1α表达水平之间有明显的差异。
结论
高血脂、高血压,PE史,DVT史,手术时间,恶性肿瘤或化疗与THA术后VTE的发生有相关性。
HSS医院人工髋关节置换病人采用多重血栓预防方案,血栓(包括深静脉血栓和肺栓塞)的发生率很低。术中的出血量很少和手术时间短,需要输血的病人和输血量都很低。而且安全可靠,与此相关的并发症也很低。
本院根据HSS的多种预防方案及本院THA术后血栓性疾病的危险因素相关性分析及本院的实际情况建立的多重预防方案。临床上运用该多重预防方案并与标准方案进行对比。血栓发生率两组没有差别,但抗凝费用上两组之间有明显的差异。进一步的研究需要大样本进行分析对比。
酶联免疫结果显示两组病人血清C-反应蛋白、肿瘤坏死因子-α、巨噬细胞炎性蛋白-1α表达水平之间有明显的差异。说明髋关节置换后及时检测、观察上述指标,如指标明显升高可能对判断髋关节置换术后是否会发生DVT具有一定实际意义。但具体的危险数值就一定会有血栓的发生还需要进一步的研究.关键词血栓性疾病人工髋关节置换多重预防方案多远回归分析血清炎性因子
Part1Investigate the incidence of clinical symtomatic VTES after THA at our hospital and analysis the main factors of VTE after THA at our hospital
1:Investigate the incidence of clinical symtomatic VTES after THA at our hospital Method:we retrospectively the298patients which performed THA at our hospital between jan,2007to Jan2010.We investigate the incidence of clinical symtomatic VTES after THA. We compare the incidence of clinical symtomatic VTES after THA between HSS and Our hospital.
2:Analysis the main factors of VTE after THA at our hospital using Multivariate statistical analysis of Discrimint analysis and Logistic regression analysis.
Part2Multimodal Prophylaxis for Venous Thromboembolism Disease after Total Hip Arthroplasty at HSS
Method
We observed993consecutive patients who had THAs performed between Jan,2006and August,2010.We excluded patients with thrombocytopenia or preexising bleeding diathesis and patients for whom epidural analgesia was not possible.The median age of the patients was64years (range,20-96years);52.8%were women (529of933));47.2%were men(473Of933);and91.9%had osteoarthritis(913of933),2.3%had osteonerrosis(23of933),2.1%had dysplasia(21of933),1.9%had rheumatoid arthritis (19of933),and1.7%had other diagnoses(17of933). Preexiting comrbidities were identified and patients were classified according to the ASA classification.
Surgery was performed by one of two surgeons (EAS, TPS). The mean operative time was83minutes.The surgeries were performed under hypotensive epidural anestheisa (mean arterial pressure between45-55mm Hg) through a posterolateral approach,minimizing the duration of femoral vein obstruction and reducing the load of intramedullary content to the venous system by repeated pulsatile lavage and aspiration of the femoral canal.The lower extremity was in the neutral position while working on the acetabulum and flexed and internally rotated while working on the femur. Whenever possible, the lower extremity was extended to a neutral position to restore femoral venous flow.Patients received one bolus of unfractionated intravenous heparin (10-15U/kg),1to2minutes before femoral canal preparation.
Postoeratively,all patients recived intermittent pneumatic compression as soon as the patient arrived to the recovery room,knee-high elastic stockings.immediate active ankle flexion and extension exercises, and early ambulation beginning on postoperative Day1.In addition,71.1%(707of933) of patients received an antiplatelet agent (325mg aspirin twice a day) and28.9%(286of933) received warfarin because of intolerance to aspirin, previous cardiac comorbidities,or a high clinical risk for thromboembolic disease.The pharmacologic prophylaxis started the night of surgery and continued for4to6weeks. Warfarin was monitored to maintain prothrombin time levels at1.8to2times control.
If there was clinical suspicion of DVT, the patients were evaluated with Doppler ultrasound and with magnetic resonance venography.DVT were classified as proximal (pelvic, femoral, popliteal) or distal (calf). Symptomatic PEs were evaluated with ventilation perfusion scans or Spiral CT. Patients had spiral comtuted tomography.All patients with a positive DVT were treated with warfarin (patients with distal DVTs for6weeks;Patients with proximal DVTs for3months).Patients with clinically symptomatic Pes,confirmed by ventilation and perfusion scans were treated with heparin followed by warfarin for3-to6months。
All patients followed up at least3months postoperatively.No patient was lost to followup.
The comparaed groups were divided into two two goups.The first one is the patients were performed THA in the second hospital afficiated with kunming medical university. We observed298consecutive patients who had THAs performed between Jan,2007and May,2011..The median age of the patients was68years (range,28-93years);52.4%were women;47.6%were men;and36.9%were femoral neck fracture;28.4%were OA,26.5%had osteonerrosis;3.5%had dysplasia(21of933),5%had rheumatoid arthritis (19of933),and1.7%had other diagnoses(17of933)2:Multivariate statistical analysis of Discrimint analysis and Logistic regression analysis for the main factors of VTE after THA
Method:We retrospectively993consecutive patients who had THAs performed between Jan,2006and August,2010.We excluded patients with thrombocytopenia or preexising bleeding diathesis and patients for whom epidural analgesia was not possible.The median age of the patients was64years (range,20-96years);52.8%were women (529of933));47.2%were men(473Of933);and91.9%had osteoarthritis(913of933),2.3%had osteonerrosis(23of933),2.1%had dysplasia(21of933),1.9%had rheumatoid arthritis (19of933),and1.7%had other diagnoses(17of933). Preexiting comrbidities were identified and patients were classified according to the ASA classification.
We analyze the main factors associated with VTE after THA using Multivariate statistical analysis of Discrimint analysis and Logistic regression analysis.
Part3Multimodal Prophylaxis for Venous Thromboembolism Disease after Total Hip Arthroplasty at our hospital
Method:We randomly divided the patients who performed THA into two groups.Group one choose mutimodal prophylaxis for VTE after THA.Group two choose standard prophylaxis for VTE after THA.
Part4Changes of the expressions of plasma inflammatory cytokine in patients with deep vein thrombosis after total hip replacement
To evaluate the changes of the expressions of tumor necrosis factor alpha (TNF-α), C-Creative Protein, macrophageinn-matoryprotein-la in patients with deep vein thrombosis (DVT) after total hip replacement (THR),30inpatients treated with THR were selected between October2010and August2012. All the patients accepted ultrasound imaging examination and various laboratory serum sampling collections voluntarily. Blood flow of deepvein in lower limbs was examined with color Doppler ultrasound in all the patients after THR. The concentrations of TNF-α,C-Creative Protein, macrophageinn-matoryprotein-la were determined with enzyme linked immunosorbent assay.
Results
Part1
1:The incidence of clinical symoptomatic VTE is6.7%(18Of298) The incidence of Deep vein thrombosis was5.3%. with prophylaxis after hip arthroplasty.
2:2:The factors including more thanHTN,,the history of DVT and PE,,duration of surgery were associated with VTEs after THA.
Part2
1:The multimodal prophylaxis protocol at HSS was associated with a low requirement of homologous blood transfusion.Comp lete information on blood loss was avaible for patients.It showed a mean preoperative hematocrit of38.6%.The mean hematocrit decrease at discharge was32%.21.1%Of patients required no blood transfusion.69.4%of the remaining patients received autologous blood,4.4%received homologous blood, and4.9%received both.The mean number of autologous units transfusion was1.09and the amount of homologous blood transfused was1.25units per patient. Among the patients receiving homologous blood,34patients received one unit,8patients received two units, and2patients received three units.
The incidence of clinical symoptomatic VTE is0.03%(13Of933) The incidence of Deep vein thrombosis was0.8%,which diagnosed with ultrasound in6patients and magnetic resonance venography in2patients.There were8proximal and distal clots.4Of the proximal clots,0were iliac,2were femoral,2were popliteal and femoral, and0was femoral and iliac. Among the DVTs dianosed in this study,6were ipsilateral,2were contralateral, and0were bilateral.5Of patients had a symptomatic PE. These were documented by ventilation and perfusion scans in4patients and bi spiral computed tomography in1patient. There was no fatal Pes.8Of these patients were diagnosed during the first postoperative week (postoperative Day 1to postoperative Day7);5VTEs developed during the second postoperative week.
Among13patients who had VTEs develop,10had clinical predisposing factors.The prevalence of synptpmatic VTEs in patients who received aspirin was0.9%(7of707) and Coumadin prophylaxis was2%(6Of286).
2:The factors including HTN,the history of DVT and PE,,duration of surgery and cheo and radio tumor with were associated with VTEs after THA.
Part3
The incidence of clinical symoptomatic VTE between Multi group and control group is no signicant diffrience (p=0.207).
There is no significant difference of bood loss and duration of surgery between the multi group and control group (P>0.05)).
There is significant difference of expence of anticoagulants between two groups (P<0.001).
Part4
The expressionsof inflammatory cytokines of TNF-α, TNF-α,C-Creative Protein, macrophageinn-matoryprotein-la postoperatively in the thrombus group were obviously higher than those in the control group (P<0.01-0.05). The expressions of related plasma inflammatory cytokines areenhanced in patients with DVT early after THR.
Conclusion
The prevalence of venous thrombolism (DVT AND PE) after Total Hip Arthroplasty is very low using Multimodal prophylaxis. The amount of blood loss in the surgery and duration time of the surgery is also low.Less patients who need transfusin and the amount of transfusion is very low.
We implemented mutlmodal prophylaxis for VTEafter THA according to the HSS protoclo and the factors which analyzed at our hospital.We compared two groups at pur hospital.The result shows The incidence of clinical symoptomatic VTE between Multi group and control group is no signicant diffrience (p=0.207) and there is no significant difference of bood loss and duration of surgery between the multi group and control group (P>0.05). There is significant difference of expence of anticoagulants between two groups (P<0.001).So we need more cases or multi center to evaluate the multi protoclo in advance.
1：通过分析本院髋关节置换病人血栓的发生率。重点关注使用抗凝方案和未使用抗凝方案之间发生率的对比。根据血栓发生病人通过多元回归分析来确定髋关节置换病人血栓发生的危险因素。
2：分析HSS医院多重血栓预防方案在全髋关节置换病人中的应用,确定该方案的有效性和安全性。
3：根据第一部分的危险因素分析、HSS医院的多重预防方案及本院的实际情况制定本院的多重血栓预防方案运用于髋关节置换的病人,并与国内标准的血栓预防方案进行对比。确定该预防方案的有效性和安全性。
4：通过髋关节置换术后发生血栓与未发生血栓病人之间血清炎性因子(C反应蛋白,肿瘤坏死因子,巨噬细胞炎性蛋白1α)对比,确定血清炎性因子与髋关节置换术后发生血栓之间的关系。
方法：
第一部分：髋关节置换术后的血栓发生率及髋关节置换术后引起血栓性疾病相关因素多元回归分析
髋关节置换术后的血栓性疾病的发生率
骨科行全髋或人工股骨头关节置换的病人共298例,从2007年1月到2010年1月。其中男性142例占病人总数47.7%,女性为156例,占病人总数的52.3%。此组病人平均年龄68(28-93),术前诊断：股骨颈骨折(Gardon三型或四型)占36.9%,骨性骨性关节炎(OA)占28.4%,股骨头坏死26.5%,内风湿性关节炎5%,髋关节发育不良3.5%,其他诊断占1.7%。术后使用下肢气压泵和低分子肝素作为血栓预防方案。
当临床上怀疑有DVT时,使用彩色Doppler或静脉造影进行检查。怀疑有PE时,使用肺血管造影检查。如果确诊为深静脉血栓,给予低分子肝素治疗。远端的DVT治疗六周,近端的DVT治疗3个月。确诊为PE采用肝素治疗3-6个月。所有的病人随访至少3个月,没有一个病人失随访。
髋关节置换术后引起血栓性疾病相关因素多元回归分析
临床资料
选取我院骨科行全髋或人工股骨头关节置换的病人共874例,从2004年1月到2010年1月。其中男性365例占病人总数41.7%,女性为509例,占病人总数的58.3%。此组病人平均年龄66(30-94),排除骨科手术原因以外引起的静脉血栓形成。其中诊断为血栓性疾病的304例。其中所有病例中采用血栓预防的为298例,占总病例数34%,发生血栓的病例数为18例,发生率为6.7%；未使用血栓预防的为576例,占总病例数的66%,发生血栓病例为286例,发生率为32.7%。
统计学方法
应用非条件Logistic回归模型进行单因素和多因素分析非条件Logistic回归分析。治疗所得资料运用SPSS17.0软件进行分析,计量资料采用均数±标准差(x±S)表示采用t检验。
第二部分HSS医院髋关节置换病人危险因素多元回归分析及多重预防方案的应用
HSS医院多重预防组病人：在纽约特种外科医院的病人共993例,其中男性473例,女性529例,从2006年1月到2010年8月在HSS行全髋关节置换手术。排除了患有血小板减少症、有出血体质以及不能行硬膜外麻醉的病人。此组病人平均年龄64Y(20从96),47.2%为男性,52.8%为女性。术前诊断：91.9%为骨性关节炎(OA),2.3%为股骨头坏死,2.1%为髋关节发育不良,1.9%为内风湿性关节炎,1.7%为其它诊断。同时对术前存在的疾病进行统计,并根据美国麻醉医师协会评分(ASA)对病人进行分级。
手术由两位医生完成(EAS,TPS),采用硬膜外低压麻醉(平均动脉压维持在45-55mmHg).手术采用后外侧切口,尽量减少股静脉扭曲的时间,反复的冲洗和吸引出股骨髓腔内容物。当处理髋臼侧的时候,下肢处于中立位置。处理股骨侧髓腔之前2-3分钟,静脉给予肝素(10-15U/kg)。此组病人平均手术时间(35min-268min),平均失血量183ml(50ml-1400ml).
术后病人一到复苏室就给与周期性加压装置,穿戴超膝的弹力袜,立即进行主动的背伸和跖屈踝关节活动,术后早期下床活动,一般为术后1-2天。术后当晚根据术前患血栓性疾病风险评估给予抗凝药物。对于风险较低的给予阿司匹林；对于术前评估患VTE风险高的病人和不能耐受阿司匹林的给予华法林,同时定期监测凝血功能,保持1NR在1.8-2.0之间。抗凝药物使用4-6周。
当病人在临床上怀疑有DVT时,使用彩色Doppler或磁共振造影进行检查；临床上怀疑PE时,使用肺血管造影扫描或螺旋CT检查。深静脉血栓根据所发生的部位分为近端(血栓在骨盆、股骨和胭血管内),远端(血栓在小腿的血管内)。有症状的PE使用肺扫描。如果确诊为深静脉血栓,给予华法林治疗。远端的DVT治疗六周,近端的DVT治疗3个月。确诊为PE采用肝素治疗3-6个月。
所有的病人随访至少3个月,没有一个病人失随访。
HSS医院髋关节置换病人危险因素多元回归分析
收集从2006年1月年到2010年8月在HSS医院行全髋关节置换术病人993例,.其中男469例,女524例。排除标准、有出血体质以及不能行硬膜外麻醉的病人。此组病人平均年龄64(20-96)),,91.3%为骨性关节炎(OA),2.3%为股骨头坏死,2.1%为髋关节发育不良,1.9%为内风湿性关节炎,1.7%为其它诊断.根据上面的分析结果进行血栓危险因素多元回归分析。
2.1统计学方法
应用非条件Logistic回归模型进行单因素和多因素分析非条件Logistic回归分析。治疗所得资料运用SPSS17.0软件进行分析,计量资料采用均数±标准差(x±S)表示采用t检验。
在SPSS17.0软件中以血栓发生(DVT和PE)为因变量；性别、年龄、体重指数、既往史、麻醉、手术时间、术前献血、血栓药物为自变量,进行Logistic多因素回归分析。P值以0.05为界,P>0.05表示差异无显著性意义,P<0.05表示差异有显著性意义。
第三部分多重血栓预防方案在我院的应用
本院多重干预组：参考HSS的多重预防方案、AAOS的预防方案以及2009年《骨科大手术静脉血栓栓塞症预防指南》与本地区所研究的血栓性发病因素特点以及本院的实际情况进行多重干预措施的制定。
术前：术前及教育病人主动背伸和跖屈踝关节,锻炼股四头肌。
术中：硬膜外麻醉；股骨侧处理和下肢位置选择,尽量降低髋关节处于屈曲位的时间；
术后：周期性充气加压装置应用；术后早期活动强有力的背伸和跖屈踝关节；术后抗凝药物采用阿司匹林。使用6-8周。
周期性充气加压装置应用：手术结束返回病房后即刻开始,间隔6h使用1次,每次使用时间1h,连续使用7d。
标准组：根据2009年《骨科大手术静脉血栓栓塞症预防指南》制定。
术中：麻醉方式由麻醉师制定；
术后：周期性加压装置的运用和踝关节主动运动；术后使用抗凝血药物：低分子肝素；
2010年10月-2012年8月在我科行髋关节置换病人共120例病人,其中男性50例,女性70例.随机分为两组。第一组为多重方案预防组,此组病人共58例,其中男性20例,女性38例,平均年龄69.06±11.42岁。第二组为标准组,此组病人共62例,其中男性30例,女性32例,平均年龄72.80±6.45岁。采用的两组病例年龄、性别,原发病及治疗术式均无显著性。
统计学方法。采用SPSS17.0统计软件,率的比较采用检验,P<0.05为差异有统计学意义。
第四部分髋关节置换后血清炎性因子表达与深静脉血栓形成的相关性研究
一般资料：本院2010年10月-2012年8月住院髋关节置换术后病例12例。均经彩色超声多普勒确立诊断为下肢深静脉栓塞。其中,男性4例,女性8例,年龄36-80岁,平均年龄64.6岁。对照组髋关节置换术后无血栓形成20例,其中男8例,女12例,年龄24-74岁,平均48.87岁。2组患者一般资料差异无统计学意义。
对下肢DVT对照组,采集晨起空腹肘静脉血5ml以109mmo1/L枸橼酸钠抗凝,迅速转移到中心实验室(时间不超过40分钟,以避免蛋白质的变性和降解)。在中心实验室内采用高速离心机进行离心,以去除细胞和杂质。剩余的存入-80℃的深低温冰箱内保存,等待酶联免疫分析检测,此过程必须在一小时内完成,避免蛋白变性和降解.C反应蛋白,肿瘤坏死因子及巨噬细胞炎性蛋白-1α酶联免疫分析采用SPSS17.0分析软件进行统计处理,实验数据以x±s表示,行t检验分析,P<0.05为差异有显著性意义,P<0.01为差异有非常显著性意义。
结果
第一部分：髋关节置换术后的血栓发生率及髋关节置换术后引起血栓性疾病相关因素多元回归分析髋关节置换术后血栓的发生率
病例共有298例,其中发生了血栓性疾病18例。占病人总数的6.7%、、其中16例为DVT,占病例总数的5.3%,其中2例为PE,占病例总数的0.67%。髋关节置换术后引起血栓性疾病相关因素多远回归分析危险因素多元回归分析：结果显示：高血压、高血脂,PE史,DVT史,恶性肿瘤放或化疗以及手术时间与THA术后VTE的发生有相关性。
第二部分HSS多重方案预防方案的应用
术前的平均HCT为38.6%,出院时平均为32.0%。术前的平均HB为13.2mg/dl,出院的平均血红蛋白为10.9mg/dl。
输血统计：共210个患者没有输血,占总数的21.1%。共783个病人接受了输血,占病人总数的78.9%；其中只输了自体血的690个,占病人总数的69.4%,占输血总人数的88.1%；,只输异体血44个,占病人总数的4.4%,占输血总人数的5.6%,两者都输的49个,占病人总数的4.9%,占输血总人数的6.2%。自体血的平均输血量为单位1.09(1-3；SD,0.3),异体血平均输血量为1.25单位(1-4；SD,0.53),。接受异体血病人中,34个接受1个单位,8个接受了2个单位,2个接受了3个单位。
本组病人共有13人发生血栓性疾病,占病人总数的1.3%。所有血栓病人中确诊为DVT的有8例,发生率为0.8%。其中彩超诊断的个6,磁共振造影诊断2个。DVT位于近端的有4个,其中0个在髂静脉,2个在股静脉,2个在胭静脉,0个髂静脉和股静脉都有,0个股静脉和胭静脉都有。DVT位于远端4个。在这些DVT病人中同侧6个,对侧2个,双侧0个。所有血栓病人中有症状并且诊断为PE的有5个,发生率为0.5%。其中肺扫描诊断4个,螺旋CT诊断1个。没有一个为致命性的PE。8个病人在术后一周确诊(术后1-7天),5个在术后第二周,0个在术后6周。
在所有13个诊断为血栓性疾病的病人中,10个术前评估有临床易感因素。接受阿司匹林的病人中7例发生VTE,占接受阿司匹林治疗患者的0.9%,其中下肢深静脉血栓4例,有症状的肺栓塞3例；接受华法林的病人中6个发生VTE,占接受华法林治疗患者的2%,其中下肢深静脉血栓5,有症状肺栓塞1例。
两组病人VTE发生率比较
多重预防方案组VTE发生率与本院298例髋关节置换术后使用抗凝方案的VTE发生率相比之间有显著性差异(1.3%对6.7%,P=0.008)
危险因素多元回归分析：
结果显示：高血压,PE史,DVT史,手术时间,恶性肿瘤或化疗于THA术后VTE的发生有相关性。
第三部分多重血栓预防方案在我院的应用
多重预防组：平均手术时间92.73±10.47min,平均手术出血量280.48±74.17,有5例发生了下肢深静脉血栓,发生率为4.16%,无一例肺栓塞。
标准组：：平均手术时间87.85±15.59min,平均手术出血量320.00±56.65ml,有7例发生了下肢深静脉血栓,发生率为5.83%,无一例肺栓塞。多重预防组于标准组比较出血量和手术时间之间有无差异性,P>0.05,血栓的发生率没有差异性,P=0.207。抗凝费用多重预防组明显低于标准组(P<0.001)
第四部分髋关节置换后血清炎性因子表达与深静脉血栓形成的相关性研究
结果：本院2010年10月-2012年8月髋关节置换病人病例12例,均经彩色多普勒确立诊断为下肢深静脉栓塞。其中,男性4例,女性8例,年龄36-80岁,平均年龄64.6岁。没有发生血栓的髋关节置换病人18例,其中男8例,女10例,年龄24-74岁,平均48.87岁。髋关节置换均由同一组骨科医师进行。30例患者中,采用气管插管全身麻醉20例,硬膜外麻醉下10例,均经髋关节外侧入路,置换方法及置换后处理均相同；5例采用骨水泥骨定,25例采用非骨水泥固定。酶联免疫结果显示两组病人血清C-反应蛋白、肿瘤坏死因子-α、巨噬细胞炎性蛋白-1α表达水平之间有明显的差异。
结论
高血脂、高血压,PE史,DVT史,手术时间,恶性肿瘤或化疗与THA术后VTE的发生有相关性。
HSS医院人工髋关节置换病人采用多重血栓预防方案,血栓(包括深静脉血栓和肺栓塞)的发生率很低。术中的出血量很少和手术时间短,需要输血的病人和输血量都很低。而且安全可靠,与此相关的并发症也很低。
本院根据HSS的多种预防方案及本院THA术后血栓性疾病的危险因素相关性分析及本院的实际情况建立的多重预防方案。临床上运用该多重预防方案并与标准方案进行对比。血栓发生率两组没有差别,但抗凝费用上两组之间有明显的差异。进一步的研究需要大样本进行分析对比。
酶联免疫结果显示两组病人血清C-反应蛋白、肿瘤坏死因子-α、巨噬细胞炎性蛋白-1α表达水平之间有明显的差异。说明髋关节置换后及时检测、观察上述指标,如指标明显升高可能对判断髋关节置换术后是否会发生DVT具有一定实际意义。但具体的危险数值就一定会有血栓的发生还需要进一步的研究.关键词血栓性疾病人工髋关节置换多重预防方案多远回归分析血清炎性因子
Part1Investigate the incidence of clinical symtomatic VTES after THA at our hospital and analysis the main factors of VTE after THA at our hospital
1:Investigate the incidence of clinical symtomatic VTES after THA at our hospital Method:we retrospectively the298patients which performed THA at our hospital between jan,2007to Jan2010.We investigate the incidence of clinical symtomatic VTES after THA. We compare the incidence of clinical symtomatic VTES after THA between HSS and Our hospital.
2:Analysis the main factors of VTE after THA at our hospital using Multivariate statistical analysis of Discrimint analysis and Logistic regression analysis.
Part2Multimodal Prophylaxis for Venous Thromboembolism Disease after Total Hip Arthroplasty at HSS
Method
We observed993consecutive patients who had THAs performed between Jan,2006and August,2010.We excluded patients with thrombocytopenia or preexising bleeding diathesis and patients for whom epidural analgesia was not possible.The median age of the patients was64years (range,20-96years);52.8%were women (529of933));47.2%were men(473Of933);and91.9%had osteoarthritis(913of933),2.3%had osteonerrosis(23of933),2.1%had dysplasia(21of933),1.9%had rheumatoid arthritis (19of933),and1.7%had other diagnoses(17of933). Preexiting comrbidities were identified and patients were classified according to the ASA classification.
Surgery was performed by one of two surgeons (EAS, TPS). The mean operative time was83minutes.The surgeries were performed under hypotensive epidural anestheisa (mean arterial pressure between45-55mm Hg) through a posterolateral approach,minimizing the duration of femoral vein obstruction and reducing the load of intramedullary content to the venous system by repeated pulsatile lavage and aspiration of the femoral canal.The lower extremity was in the neutral position while working on the acetabulum and flexed and internally rotated while working on the femur. Whenever possible, the lower extremity was extended to a neutral position to restore femoral venous flow.Patients received one bolus of unfractionated intravenous heparin (10-15U/kg),1to2minutes before femoral canal preparation.
Postoeratively,all patients recived intermittent pneumatic compression as soon as the patient arrived to the recovery room,knee-high elastic stockings.immediate active ankle flexion and extension exercises, and early ambulation beginning on postoperative Day1.In addition,71.1%(707of933) of patients received an antiplatelet agent (325mg aspirin twice a day) and28.9%(286of933) received warfarin because of intolerance to aspirin, previous cardiac comorbidities,or a high clinical risk for thromboembolic disease.The pharmacologic prophylaxis started the night of surgery and continued for4to6weeks. Warfarin was monitored to maintain prothrombin time levels at1.8to2times control.
If there was clinical suspicion of DVT, the patients were evaluated with Doppler ultrasound and with magnetic resonance venography.DVT were classified as proximal (pelvic, femoral, popliteal) or distal (calf). Symptomatic PEs were evaluated with ventilation perfusion scans or Spiral CT. Patients had spiral comtuted tomography.All patients with a positive DVT were treated with warfarin (patients with distal DVTs for6weeks;Patients with proximal DVTs for3months).Patients with clinically symptomatic Pes,confirmed by ventilation and perfusion scans were treated with heparin followed by warfarin for3-to6months。
All patients followed up at least3months postoperatively.No patient was lost to followup.
The comparaed groups were divided into two two goups.The first one is the patients were performed THA in the second hospital afficiated with kunming medical university. We observed298consecutive patients who had THAs performed between Jan,2007and May,2011..The median age of the patients was68years (range,28-93years);52.4%were women;47.6%were men;and36.9%were femoral neck fracture;28.4%were OA,26.5%had osteonerrosis;3.5%had dysplasia(21of933),5%had rheumatoid arthritis (19of933),and1.7%had other diagnoses(17of933)2:Multivariate statistical analysis of Discrimint analysis and Logistic regression analysis for the main factors of VTE after THA
Method:We retrospectively993consecutive patients who had THAs performed between Jan,2006and August,2010.We excluded patients with thrombocytopenia or preexising bleeding diathesis and patients for whom epidural analgesia was not possible.The median age of the patients was64years (range,20-96years);52.8%were women (529of933));47.2%were men(473Of933);and91.9%had osteoarthritis(913of933),2.3%had osteonerrosis(23of933),2.1%had dysplasia(21of933),1.9%had rheumatoid arthritis (19of933),and1.7%had other diagnoses(17of933). Preexiting comrbidities were identified and patients were classified according to the ASA classification.
We analyze the main factors associated with VTE after THA using Multivariate statistical analysis of Discrimint analysis and Logistic regression analysis.
Part3Multimodal Prophylaxis for Venous Thromboembolism Disease after Total Hip Arthroplasty at our hospital
Method:We randomly divided the patients who performed THA into two groups.Group one choose mutimodal prophylaxis for VTE after THA.Group two choose standard prophylaxis for VTE after THA.
Part4Changes of the expressions of plasma inflammatory cytokine in patients with deep vein thrombosis after total hip replacement
To evaluate the changes of the expressions of tumor necrosis factor alpha (TNF-α), C-Creative Protein, macrophageinn-matoryprotein-la in patients with deep vein thrombosis (DVT) after total hip replacement (THR),30inpatients treated with THR were selected between October2010and August2012. All the patients accepted ultrasound imaging examination and various laboratory serum sampling collections voluntarily. Blood flow of deepvein in lower limbs was examined with color Doppler ultrasound in all the patients after THR. The concentrations of TNF-α,C-Creative Protein, macrophageinn-matoryprotein-la were determined with enzyme linked immunosorbent assay.
Results
Part1
1:The incidence of clinical symoptomatic VTE is6.7%(18Of298) The incidence of Deep vein thrombosis was5.3%. with prophylaxis after hip arthroplasty.
2:2:The factors including more thanHTN,,the history of DVT and PE,,duration of surgery were associated with VTEs after THA.
Part2
1:The multimodal prophylaxis protocol at HSS was associated with a low requirement of homologous blood transfusion.Comp lete information on blood loss was avaible for patients.It showed a mean preoperative hematocrit of38.6%.The mean hematocrit decrease at discharge was32%.21.1%Of patients required no blood transfusion.69.4%of the remaining patients received autologous blood,4.4%received homologous blood, and4.9%received both.The mean number of autologous units transfusion was1.09and the amount of homologous blood transfused was1.25units per patient. Among the patients receiving homologous blood,34patients received one unit,8patients received two units, and2patients received three units.
The incidence of clinical symoptomatic VTE is0.03%(13Of933) The incidence of Deep vein thrombosis was0.8%,which diagnosed with ultrasound in6patients and magnetic resonance venography in2patients.There were8proximal and distal clots.4Of the proximal clots,0were iliac,2were femoral,2were popliteal and femoral, and0was femoral and iliac. Among the DVTs dianosed in this study,6were ipsilateral,2were contralateral, and0were bilateral.5Of patients had a symptomatic PE. These were documented by ventilation and perfusion scans in4patients and bi spiral computed tomography in1patient. There was no fatal Pes.8Of these patients were diagnosed during the first postoperative week (postoperative Day 1to postoperative Day7);5VTEs developed during the second postoperative week.
Among13patients who had VTEs develop,10had clinical predisposing factors.The prevalence of synptpmatic VTEs in patients who received aspirin was0.9%(7of707) and Coumadin prophylaxis was2%(6Of286).
2:The factors including HTN,the history of DVT and PE,,duration of surgery and cheo and radio tumor with were associated with VTEs after THA.
Part3
The incidence of clinical symoptomatic VTE between Multi group and control group is no signicant diffrience (p=0.207).
There is no significant difference of bood loss and duration of surgery between the multi group and control group (P>0.05)).
There is significant difference of expence of anticoagulants between two groups (P<0.001).
Part4
The expressionsof inflammatory cytokines of TNF-α, TNF-α,C-Creative Protein, macrophageinn-matoryprotein-la postoperatively in the thrombus group were obviously higher than those in the control group (P<0.01-0.05). The expressions of related plasma inflammatory cytokines areenhanced in patients with DVT early after THR.
Conclusion
The prevalence of venous thrombolism (DVT AND PE) after Total Hip Arthroplasty is very low using Multimodal prophylaxis. The amount of blood loss in the surgery and duration time of the surgery is also low.Less patients who need transfusin and the amount of transfusion is very low.
We implemented mutlmodal prophylaxis for VTEafter THA according to the HSS protoclo and the factors which analyzed at our hospital.We compared two groups at pur hospital.The result shows The incidence of clinical symoptomatic VTE between Multi group and control group is no signicant diffrience (p=0.207) and there is no significant difference of bood loss and duration of surgery between the multi group and control group (P>0.05). There is significant difference of expence of anticoagulants between two groups (P<0.001).So we need more cases or multi center to evaluate the multi protoclo in advance.
引文
1. Johnson R, Green JR, Charnley J. Pulmonary embolism and its prophylaxis following the charnley total hip replacement. Clin Orthop.1977(127):123-32.
2. Coventry MB, Beckenbaugh RD, Nolan DR, et al.2,012 total hip arthroplasties. A study of postoperative course and early complications. J Bone Joint Surg Am. 1974 Mar; 56(2):273-84.
3. DiGiovanni CW, Restrepo A, Gonzalez Della Valle AG, et al. The safety and efficacy of intraoperative heparin in total hip arthroplasty. Clin Orthop.2000 Oct; 379:178-85.
4. Salvati EA, Gonzalez Delia Valle A. Thromboembolism following total hip replacement. J Long Term Eff Med Implants.2003; 13(4):325-40.
5. Salvati E, Sharrock NE, Westrich G, et al. Nicholas andry award:Three decades of clinical, basic and applied research on thromboembolic disease after total hip arthroplasty. The rationale and clinical results of a multimodal prophylaxis protocol. Clin Orthop.2007; Jun;459:246-54
6. Mohr DN, Silverstein MD, Ilstrup DM, et al. Venous thromboembolism associated with hip and knee arthroplasty:Current prophylactic practices and outcomes. Mayo Clin Proc.1992 Sep; 67(9):861-70.
7. Warwick D, Williams MH, Bannister GC. Death and thromboembolic disease after total hip replacement. A series of 1162 cases with no routine chemical prophylaxis. J Bone Joint Surg Br.1995 Jan; 77(1):6-10.
8. Lieberman JR, Wollaeger J, Dorey F, et al. The efficacy of prophylaxis with low-dose warfarin for prevention of pulmonary embolism following total hip arthroplasty. J Bone Joint Surg Am.1997 Mar; 79(3):319-25.
9. Westrich GH, Farrell C, Bono JV, et al. The incidence of venous thromboembolism after total hip arthroplasty:A specific hypotensive epidural anesthesia protocol. J Arthroplasty.1999 Jun; 14(4):456-63.
10. Sarmiento A, Goswami AD. Thromboembolic prophylaxis with use of aspirin, exercise, and graded elastic stockings or intermittent compression devices in patients managed with total hip arthroplasty. J Bone Joint Surg Am.1999 Mar; 81(3):339-46.
11. Salvati EA, D. PV, Jr, Sharrock NE, et al. Recent advances in venous thromboembolic prophylaxis during and after total hip replacement. J Bone Joint Surg Am.2000 Feb; 82(2):252-70.
12. Phillips CB, Barrett JA, Losina E, et al. Incidence rates of dislocation, pulmonary embolism, and deep infection during the first six months after elective total hip replacement. J Bone Joint Surg Am.2003 Jan; 85-A(1):20-6.
13. Gonzalez Della Valle A, Serota A, Sorriaux G, et al. Venous thromboembolism is rare after total hip arthroplasty with a multimodal prophylaxis protocol. Clin Orthop.2006; 443:146-53.
14. Murray DW, Carr AJ, Bulstrode CJ. Pharmacological thromboprophylaxis and total hip replacement. J Bone Joint Surg Br.1995 Jan; 77(1):3-5.
15. Alejandro Gonzalez Della Valle;Francis Jeshira Reynoso;Judith Ben Ari;Eduardo Salvati;鲁宁.多重方法预防髋膝关节置换术后的血栓性疾病中华关节外科杂志(电子版)2011,5；2：53-57
16. Cusick LA, Beverland DE. The incidence of fatal pulmonary embolism after primary hip and knee replacement in a consecutive series of 4253 patients. J Bone Joint Surg Br.2009 May; 91(5):645-8.
17. Sachs RA, Smith JH, Kuney M, et al. Does anticoagulation do more harm than good:A comparison of patients treated without prophylaxis and patients treated with low-dose warfarin after total knee arthroplasty. J Arthroplasty.2003 Jun; 18(4):389-95.
18.Dhillon KS, Askander A, Doraismay S. Postoperative deep-vein thrombosis in Asian patients is not a rarity:a prospective study of 88 patients with no prophylaxis. J Bone Joint Surg Br.1996;78(3):427-430.
19 Kew J, Lee YL, Davey IC,et al. Deep vein thrombosis in elderly Hong Kong Chinese with hip fractures detected with compression ultrasound and Doppler imaging:incidence and effect of low molecular weight heparin. Arch Orthop Trauma Surg.1999; 119(3-4):156-158.
20.吕厚山,徐斌.人工关节置换术后下肢深静脉血栓形成[J].中华骨科杂志,1999,19(3)：155-156.
21.邱贵兴杨庆铭余楠生等-低分子肝素预防髋、膝关节手术后下肢深静脉血栓形成的多中心研究。中华骨科杂志.2006,12：819
22.壬玉琦,叶建荣.血管外科学治疗学[M].上海：上海科学技术出版社,2003,216-218.
23.唐孝明,裴福兴,沈彬.麻醉对人工全髋关节置换术后深静脉血栓形成的影响[J].骨与关节损伤杂志,2002,05(3).
24.臧学慧；查振刚；冯永洪；高立华；孙辉.全髋关节置换后早期并发深静脉血栓的多因素Logistic回归分析；-《中国组织工程研究与临床康复》-2010-04-23
25陆芸.码宗通,郭若霖.等.骨科创伤患者深静脉血栓危险因素的研究.中华骨科杂志,2007,27(9)：693—698.
26.曲洪雩,刘厶鹏.骨科深静脉血栓形成危险冈素及发病机制的研究进展[J].中国矫形外科杂志,2009.17(2)：110—112.
27.扬兴光,孙忠,王学谦,等.骨折术后深静脉栓塞的危险因素分析.天津医药,2010,38(6)：464—466.
28.韩伟峰,黄新天.殷敏毅.等.下肢深静脉血栓形成的临床流行病学研究.中华普通外科杂志,2009,24(1)：30一33.
29.Tai YF. An association between atherosclerosis and venous thrombosis. N Engl J Med.2003;349(4):401-402.
30.魏鹤新.骨科大手术前后深静脉血栓的预防[J].中国实用医药,
31.殷婷,王凌云.陈明莹.等.全髋置换术后深静脉血栓形成相关因素分析[J].中国煤炭工业医学,2002,5(11)：1103.
32.吕厚山,徐斌.人工髋关节置换术后下肢深静脉血栓形成[J].中华骨科杂志,2002.18(2)：55.
33.李进.骨科手术后深静脉血栓形成的预防分析[J].现代医药卫生,2007,4：521-522
34. Stein PD, Kayali F, Olson RE, et al. Pulmonary thromboembolism in American Indians and Alaskan natives. Arch Intern Med,2004, 164:1804.1806.
35杨刚,吕厚山,高健等.低分子肝素预防人工髋、膝关节置换术后下肢深静脉血栓形成的研究,中华外科杂志,2000,38,25-27
36.韦利芳.预防全懿关节置换术后下肢深静脉血栓形成的护理进展[J].中外健康文摘,2011,1
37.梁观宝,何伟东.磁治疗带预防髋膝关节术后下肢深静脉血栓形成[J].中国康复,2002,17(2)：90-91.
38.代杰,曹飞.疏血通注射液预防下肢人工关节簧换术后深静脉栓塞的应用[J].中国社区医师,2008,10(179)：56
39刘天盛,苏彬,王字强,等.活血通脉胶囊联合周期性充气加压预防髋部骨折手术后深静脉栓塞[J].武警医学院学报,2008,17(5)：415-419.
40.林守清.女性围绝经期激素治疗国内外近期临床应用进展[J].中国实用妇科与产科杂志,2006,01
41.宋琳琳.髋、膝关节矫形术和髋部骨折内固定术后病人下肢深静脉血栓形成的危险因素[J].中华麻醉学杂志,2008,3：205-207
42.张伯英.麻醉对DVT形成的影响[J].中华现代临床医学杂志,2004,2(8B)
43. Walsh JJ,Bonnar J,Wright FW. A study of pulmonary embolism and deep leg vein thrombosis after major gynecologic surgery using labeled fribinogen-phlegbograpgy and lung scanning.J Obstet Gynecol Br Commonw,1974,81:311-316
44. Clarke-Pearson DL,Jelovesk FR,Creasman WT.Thromboembolism complicating surgery for cervical and uterine malignancy:incidence,risk factors, and prophylaxis.Obstet Gynecol,1983,61:87-94.
45. Goldhaber SE.Epidemiology of pulmonary embolism and deep vein-thrombosis. In:Bloom Al, Forbes CD, Thomas DP, eds.Haemostasis and thrombosis. London:Churchill,1994,1327
46. Thomas DP. Pathogenesis of venous thrombosis. In:Bloom Al, Fobes CD,Thomas DP, eds.Haemostasis and thrombosis. London:Churchill,1994,1335
47 Allaart CF,Briei E.Familial venous thrombophilia. In:Bloom AL,Forbes CD,Thomas DP, eds. Haemostasis and thrombosis. London:Churchill, 1994,1349
48. Begamini TM,Richardson JD.The surgical implications of prinary hypercoagulation status.J Ky Med Assoc,1997,2:67-72
49. Salvati EA, Sharrock NE, Westrich G, et al. The 2007 ABJS nicolas andry award: Three decades of clinical, basic, and applied research on thromboembolic disease after THA:Rationale and clinical results of a multimodal prophylaxis protocol. Clinical orthopaedics and related research.2007 Jun; 459:246-54.
50. Sharrock NE, Gonzalez Della Valle A, Go G, et al. Potent anticoagulants are associated with a higher all-cause mortality rate after hip and knee arthroplasty. Clinical orthopaedics and related research.2008 Mar; 466(3):714-21.
51. Sharrock NE, Gonzalez Della Valle A, and Go G, et al. Reply to letter to editor: Potent anticoagulants are associated with a higher all-cause mortality rate after hip and knee arthroplasty. Clinical orthopaedics and related research.2008 Jun 4:234-236
52. Beksac B, Gonzalez Della Valle A, and Salvati EA. Thromboembolic disease after total hip arthroplasty:Who is at risk? Clin Orthop Relat Res.2006; 453:211-24.
53. Bae H, Westrich GH, Sculco TP, et al. The effect of preoperative donation of autologous blood on deep-vein thrombosis after total hip arthroplasty. J Bone Joint Surg Br.2001 Jul; 83(5):676-9.
54. Sharrock NE, Fischer G, Goss S, et al. The early recovery of cognitive function after total-hip replacement under hypotensive epidural anesthesia. Reg Anesth Pain Med.2005 Mar-Apr; 30(2):123-7.
55. Modig J. Beneficial effects on intraoperative and postoperative blood loss in total hip replacement when performed under lumbar epidural anesthesia. An explanatory study. Acta Chir Scand Suppl.1989; 550:95,100; discussion 100-3.
56. Davis FM, Laurenson VG, Gillespie WJ, et al. Deep vein thrombosis after total hip replacement. A comparison between spinal and general anaesthesia. J Bone Joint Surg Br.1989 Mar; 71(2):181-5.
57. Modig J, Borg T, Karlstrom G, et al. Thromboembolism after total hip replacement: Role of epidural and general anesthesia. Anesth Analg.1983 Feb; 62(2):174-80.
58. Wille-Jorgensen P, Christensen SW, Bjerg-Nielsen A, et al. Prevention of thromboembolism following elective hip surgery. The value of regional anesthesia and graded compression stockings. Clin Orthop.1989 Oct; 247:163-7.
59. Prins MH, Hirsh J. A comparison of general anesthesia and regional anesthesia as a risk factor for deep vein thrombosis following hip surgery:A critical review. Thromb Haemost.1990 Dec 28; 64(4):497-500.
60. Sharrock NE, Salvati EA. Hypotensive epidural anesthesia for total hip arthroplasty:A review. Acta Orthop Scand.1996 Feb; 67(1):91-107.
61. Sharrock NE, Cazan MG, Hargett MJ, et al. Changes in mortality after total hip and knee arthroplasty over a ten-year period. Anesth Analg.1995 Feb; 80(2):242-8.
62. Sharrock NE, Mineo R, Urquhart B, et al. The effect of two levels of hypotension on intraoperative blood loss during total hip arthroplasty performed under lumbar epidural anesthesia. Anesth Analg.1993 Mar; 76(3):580-4.
63. Sharrock NE, Go G, Harpel PC, et al. The john charnley award. Thrombogenesis during total hip arthroplasty. Clin Orthop.1995 Oct; 319:16-27.
64. Pitto RP, Koessler M, Draenert K. The john charnley award. prophylaxis of fat and bone marrow embolism in cemented total hip arthroplasty. Clin Orthop.1998 Oct; 355:23-34.
65. Sharrock N, Go G, Mayman D, et al. Decreases in pulmonary artery oxygen saturation during total hip arthroplasty. Variations using two leg positioning techniques. J Arthroplasty.2005; 20(4):499-502.
66. Hooker JA, Lachiewicz PF, Kelley SS. Efficacy of prophylaxis against thromboembolism with intermittent pneumatic compression after primary and revision total hip arthroplasty. J Bone Joint Surg Am.1999 May; 81(5):690-6.
67. Macaulay W, Westrich G, Sharrock N, et al. Effect of pneumatic compression on fibrinolysis after total hip arthroplasty. Clin Orthop.2002 Jun; 399:168-76.
68. Ryan MG, Westrich GH, Potter HG, et al. Effect of mechanical compression on the prevalence of proximal deep venous thrombosis as assessed by magnetic resonance venography. J Bone Joint Surg Am.2002 Nov; 84-A(11):1998-2004.
69. Westrich GH, Specht LM, Sharrock NE, et al. Pneumatic compression hemodynamics in total hip arthroplasty. Clin Orthop.2000 Mar; 372:180-91.
70. Markel DC, Urquhart B, Derkowska I, et al. Effect of epidural analgesia on venous blood flow after hip arthroplasty. Clin Orthop.1997 Jan; 334:168-74.
71. Prandoni P, Lensing AW, Prins MH, et al. Below-knee elastic compression stockings to prevent the post-thrombotic syndrome:A randomized, controlled trial. Ann Intern Med.2004 Aug 17; 141(4):249-56.
72. Geerts WH, Pineo GF, Heit JA, et al:Prevention of venous thromboembolism: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 2004; 126(3 suppl):338S-400S
73.Heit JA,O'fallon WM, Petterson TM,et al. Relative impact of risk factors for deep vein thrombosis and pulmonary embolism:a population-based study. Arch Intern Med.2002; 162:1245-1248
74. Thodiyil PA, Kakkar AK. Variation in relative risk of venous thromboembolism in different cancers. Thromb Haemost.2002; 87:1076-1077
75. Murin S, Romano PS, White RH.Comparison of outcomes after hospitalization for deep venous thrombosis or pulmonary embolism. Thromb Haemost.2002; 88:407-414
76. Fisher B,Costantino JP,Wickerhan DL,et al.Tamoxifen for prevention of breast cancer:report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study J Natl Cancer Inst.1998;90:1371-1388
77. Cummings SR, Eckert S, Krueger KA, et al. The effect of raloxifene on risk of breast cancer in postmenopausal women:results from the MORE randomized trial. JAMA.1999; 281:2189-2197
78. Gomes MP,Deitcher SR. Risk of venous thromboembolic disease associated with hormonal contraceptives and hormone reolacement therapy:a clinical review.Arch Intern Med.2004;164:1965-1976
79. Rosendaal FR, Helmerhorst FM, Vandenbroucke JP. Female hormones and thrombosis. Arterioscler Thromb Vase Biol.2002; 22:201-210
80. Grady D,Wenger NK,Herrington D,et al. Postmenopausal hormone therapy increases risk for venous thrombo-embolic disease:the Heart and Estrogen/progestin Replacement Study. Ann Intern Med.2000; 132:689-696
81. Mantilla CB,Horlocker TT,Schroeder DR,et al. Risk factors for clinically relavent pulmonary embolism and deep venous thrombosis in patients undergoing primary hip or knee arthroplasty. Anesthesiology 2003; 99:552-560
82. Lowe GD,Haverkate F,Thompson SG,et al. Prediction of deep vein thrombosis after elective replacemehe ECAT DVTnt hip surgery by preoperative clinical and haemostatic variables:the ECAT DVT Study:European Concerted Action on Thrombosis.Thromb Haemost 1999; 81:879-886
83. Glimore R,Doyle M,Holden F,et al. Activated protein C resistance factor V Leiden and assessment of thrombotic risk.Ir Med J 2008; 101:256-257
84. Prevention of venous thrombosis and pulmonary embolism:NIH Consensus Development. JAMA 1986; 256:744-799
85 Weinmann, E, Salzman, E. W:Deep-vein thrombosis. New England J. Med., 1994331:1630-1641
86 Warwick D, Williams MH, Bannister GC. Death and thromboembolic disease after total hip replacement A series of 1162 cases with no routine chemical prophylaxis. J Bone Joint Surg Br 1995; 77-B (1):6-10
87. Geerts WH, Bergqvist D, Pineo GF, et al. Prevention of venous thromboembolism: American college of chest physicians evidence-based clinical practice guidelines.8th edition. Chest 2008; 133(Suppl 6):381S-453
88 Trousseau A. Lectures on clinical medicine delivered at the Hotel-Dieu ParisLondon:New Sydenham Society; 1865. P228-332.
89. Bottner F,Sculco TP;Nonpharmacologic thromboembolic prophylaxis in total knee arthroplasty. Clin Orthop Relat Res 2001,392:249-256
90. Epidemiology, risk factors, Pathophysiology and Pathogenesis.Respiration 2003, 70:7-30
91. Ferrari E,Baudouy M, Cerboni P;Clinical epidemiology of venous thromboembolic disease.Results of a French multicenter registry.Eur Heart J 1997,18:685-89
92. Trigillo-Santos AJ, Jines Punte.Association between long travel and venous thromboembolic disease:A systemtic review and meta-analysis of control studies. Ann Hematol 2008,87:79-86
93. TomassonQ Monach PA, Thromboembolic disease in vasculitis.Curr Opin Rheumatol 2009,21:41-46
94. Westrich GH, Specht LM, Sharrock NE. Pneumatic compression Hemodynamics in total hip arthroplasty. Clin Orthop Relat Res.2000; 372:180-191.
95. Sharrock NE, Go G, Harpel PC, et al. The John Charnley Award. Thrombogenesis during total hip arthroplasty. Clin Orthop Relat Res.1995; 319:16-27.\
96. Planes MH, Hirsh A, Total hip replacement and deep vein thrombosis. J-Bone Joint Surg Br 1990; 72,9-13
97 Ay C,Junbauer Lv, High concentrations of solube P-selection are associated with risk of venous thromboembolism and the P-selection.The 715 variants,Clin Chem 2007,53:1235-1243
98. Imperiale TF, Speroff T. A meta-analysis of methods to prevent venous thromboembolism following total hip replacement. Jama.1996 Jun 8; 271(22):1780-5.
99. Beksac B, Gonzalez Delia Valle A, and Salvati EA. Thromboembolic disease after total hip arthroplasty:Who is at risk? Clin Orthop Relat Res.2006;453:211-24
100Butt AJ, McCarthy T, Kelly IP, et al. Sciatic nerve palsy secondary to postoperative haematoma in primary total hip replacement. J Bone Joint Surg Br. 2005 November 1,2005; 87-B (11):1465-7.
101. Callaghan JJ, Dorr LD, Engh GA, et al. Prophylaxis for thromboembolic disease. J Arthroplasty.2005 Apr; 20(3):273-4.
102. Freedman KB, Brookenthal KR, H. FR,Jr, et al. A meta-analysis of thromboembolic prophylaxis following elective total hip arthroplasty. J Bone Joint Surg Am.2000 Jul; 82-A (7):929-38.
103. Friedman RJ, Dunsworth GA. Cost analyses of extended prophylaxis with enoxaparin after hip arthroplasty. Clin Orthop.2000 Jan (370):171-82.
104. Imperiale TF, Speroff T. A meta-analysis of methods to prevent venous thromboembolism following total hip replacement. Jama.1994 Jun 8; 271(22):1780-5.
105. Salvati EA, Sharrock NE, Gonzalez Della Valle A. Current concepts in the pathogenesis, diagnosis and multimodal prophylaxis of thromboembolism disease following total hip replacement. Minerva Ortopedica e Traumatologica. 2003;54(5):381-401.
106. Shaieb MD, Watson BN, Atkinson RE. Bleeding complications with enoxaparin for deep venous thrombosis prophylaxis. J Arthroplasty.1999 Jun; 14(4):432-8.
107. Beksac BP, Gonzalez Della Valle A, Salvati EA. Acute sciatic nerve palsy as a delayed complication of low-molecular-weight heparin prophylaxis after total hip arthroplasty. Am J Orthop.2009 Feb; 38(2):E28-30.
108. W. CC, Jr, Berkowitz SD, Lieberman JR, et al. Oral direct thrombin inhibitor ximelagatran compared with warfarin for the prevention of venous thromboembolism after total knee arthroplasty. J Bone Joint Surg Am.2005 Oct; 87(10):2169-77.
109. Dearborn JT, Harris WH. Postoperative mortality after total hip arthroplasty. An analysis of deaths after two thousand seven hundred and thirty-six procedures. J Bone Joint Surg Am.1998 Sep; 80(9):1291-4.
110. D. PV, Jr, Donaldson CT, Farber DC, et al. The John charnley award:Prevention of readmission for venous thromboembolic disease after total hip arthroplasty. Clin Orthop Relat Res.2005 Dec; 441:56-62.
111. Planes A, Samama MM, Lensing AW, et al. Prevention of deep vein thrombosis after hip replacement--comparison between two low-molecular heparins, tinzaparin and enoxaparin. Thromb Haemost.1999 Jan; 81(1):22-5.
112 Lachiewicz PF, Kelley SS, Haden LR. Two mechanical devices for prophylaxis of thromboembolism after total knee arthroplasty. A prospective, randomised study. J Bone Joint Surg Br.2004 Nov; 86(8):1137-41.
113 Mantilla CB, Horlocker TT, Schroeder DR, et al. Risk factors for clinically relevant pulmonary embolism and deep venous thrombosis in patients undergoing primary hip or knee arthroplasty. Anesthesiology.2003 Sep; 99(3):552,60; discussion 5A.
114. Memtsoudis SG, Besculides MC, Gaber L, et al. Risk factors for pulmonary embolism after hip and knee arthroplasty:A population-based study. Int Orthop. 2008 Oct 17
115 Lieberman JR. Venous thromboembolism after total hip arthroplasty In: Callaghan JJ, Rosenberg AG, Rubash HE, editors. The Adult Hip. Philadelphia: Lippincott-Raven; 1998; p.633-46.
116. Mantilla CB, Horlocker TT, Schroeder DR, et al. Frequency of myocardial infarction, pulmonary embolism, deep venous thrombosis, and death following primary hip or knee arthroplasty. Anesthesiology.2002 May; 96(5):1140-6.
117. Salvati EA, Gonzalez Della Valle A, Westrich GH, et al. The John charnley award: Heritable thrombophilia and development of thromboembolic disease after total hip arthroplasty. Clin Orthop Relat Res.2005 Dec; 441:40-55.
118 Miles JS, Miletich JP, Goldhaber SZ, et al. G20210A mutation in the prothrombin gene and the risk of recurrent venous thromboembolism. J Am Coll Cardiol. 2001 Jan; 37(1):215-8.
119. Pabinger I, Grafenhofer H, Kaider A, et al. Preeclampsia and fetal loss in women with a history of venous thromboembolism. Arterioscler Thromb Vase Biol.2001 May; 21(5):874-9.
120. Westrich GH, Weksler BB, Glueck CJ, et al. Correlation of thrombophilia and hypofibrinolysis with pulmonary embolism following total hip arthroplasty:An analysis of genetic factors. J Bone Joint Surg Am.2002 Dec; 84-A (12):2161-7.
121. Gomes MPV, Deitcher SR. Risk of venous thromboembolic disease associated with hormonal contraceptives and hormone replacement therapy:A clinical review. Arch Intern Med.2004 October 11,2004; 164(18):1965-76.
122. Rosendaal FR, Helmerhorst FM, Vandenbroucke JP. Female hormones and thrombosis. Arterioscler Thromb Vase Biol.2002 February 1,2002; 22(2):201-10.
123Beksac B, Gonzalez Della Valle A, Anderson J, et al. Symptomatic thromboembolism after one-stage bilateral THA with a multimodal prophylaxis protocol. Clin Orthop Relat Res.2007 Oct; 463:114-9.
124 Anders MJ,Lifeso RM,Landis M,et al. Effect of preoperative donation of autologous blood on deep-vein thrombosis following total joint arthroplasty of the hip or knee.J Bone Joint Surg Am 1996;78-A:574-80
125.Pearson TC. Heamorheologic considerations in the pathogenesis of vascular occlusive events in polycythemia vera.Semi thromb Hemost 1997; 23:433-9
126. Manouri Taleghani B,Manke F,Langer R,et al.Changes in blood rheology and microcirculation after preparatory combined thrombocytopheresis and plasmaphresis.Beitr infusionsher Transfusionsmed 1997;34:123-7
127.Blachman MA, Bordin JO, Bardossy L, et al. The contribution of the haematocrit to thrombocytopenic bleeding in experimental animals. Br J Haematol 1994; 86:2347-50
128. Dietrich QKretschmer V,Orth D,et al. Primary hemostasis in hemodilution-1 Hemocrit. Infusionstherapie 1990; 17:212-3
129. Dietrich G, Orth D, Haupt Wrimary hemostasisi in hemod, et al. Primary hemostasis in hemodilution-2 infusion solutions. Infusiontherapie 1990; 17:214-6
130.Valeri DR,Macgregor H,Cassidy Q et al.Effects of temperature on bleeding time and clotting time in normal male and female volunteers. Crit Care Med 1995; 23:698-704
131. Cabibbo S, Garozzo G, Antolino A, et al. Continuous improvement of our autologous blood donation program carried out during 10 years in 1198 orthopaedic patients Transfus Apher Sci.2009 Feb; 40(1):13-7
132. Kubota R, Nozawa M, Matsuda K,et al. Combined preoperative autologous blood donation and intra-operative cell salvage for hip surgery J Orthop Surg (Hong Kong).2009 Dec; 17(3):288-90.
133. Modig J. Influence of regional nesthesia.local anesthetics and sympathicominmetics on the pathophysiology of deep vein thrombosis.Acta Chir Scand Suppl 1989; 550:119-27
134. Sharrock NE,Go G,Mineo R;The hemodynamic and fibrinolytic response to low dose epinephrine and phenlephrine infusions during total hip replacement under epidural anesthesia. Thromb Haemost 1992;68:436-41
135. Sculco TP, Ranawat C. The use of spinal anesthesia for total hip-replacement arthroplasty. J Bone Joint Surg Am.1975 Mar; 57(2):173-7.
136.Brooks PJ, Keramati M, Wickline A. Thromboembolism in patients undergoing total knee arthroplasty with epidural analgesia. J Arthroplasty.2007 Aug; 22(5):641-3.
137. Bading B, Blank SG, Sculco TP, et al. Augmentation of calf blood flow by epinephrine infusion during lumbar epidural anesthesia. Anesth Analg.1994 Jun; 78(6):1119-24.
138 Mineo R, Sharrock NE. Pulse oximeter waveforms from the finger and toe during lumbar epidural anesthesia. Reg Anesth.1993 Mar-Apr; 18(2):106-9
139 Williams-Russo P, Sharrock NE, Mattis S, et al. Cognitive effects after epidural vs general anesthesia in older adults. A randomized trial. Jama.1995 Jul 5; 274(1):44-50
140. Gitel SN, Salvati EA, Wessler S, et al. The effect of total hip replacement and general surgery on antithrombin Ⅲ in relation to venous thrombosis. J Bone Joint Surg Am.1979 Jul; 61(5):653-6.
141. Huo MH, Salvati EA, Sharrock NE, et al. Intraoperative adjusted-dose heparin thromboembolic prophylaxis in primary total hip arthroplasty. Clin Orthop.1992 Apr; 277:188-96.
142. Huo MH, Salvati EA, Sharrock NE, et al. Intraoperative heparin thromboembolic prophylaxis in primary total hip arthroplasty. A prospective, randomized, controlled, clinical trial. Clin Orthop Relat Res.1992 Jan;(274) (274):35-46.
143. Sharrock NE, Brien WW, Salvati EA, et al. The effect of intravenous fixed-dose heparin during total hip arthroplasty on the incidence of deep-vein thrombosis. A randomized, double-blind trial in patients operated on with epidural anesthesia and controlled hypotension. J Bone Joint Surg Am.1990 Dec; 72(10):1456-61.
144. Dahl OE. The role of the pulmonary circulation in the regulation of coagulation and fibrinolysis in relation to major surgery. J Cardiothorac Vase Anesth.1997 May; 11(3):322-8.
145. Sharrock NE, Go G, Sculco TP, et al. Dose response of intravenous heparin on markers of thrombosis during primary total hip replacement. Anesthesiology. 1999 Apr; 90(4):981-7.
146. Westrich GH, Salvati EA, Sharrock N, et al. The effect of intraoperative heparin administered during total hip arthroplasty on the incidence of proximal deep vein thrombosis assessed by magnetic resonance venography. J Arthroplasty.2005 Jan; 20(1):42-50.
147.Binns M, Pho R. Femoral vein occlusion during hip arthroplasty. Clin Orthop. 1990 Jun; 255:168-72.
148. Stamatakis JD, Kakkar VV, Sagar S, et al. Femoral vein thrombosis and total hip replacement. Br Med J.1977 Jul 23; 2(6081):223-5.
149. Christie J, Robinson CM, Singer B, et al. Medullary lavage reduces embolic phenomena and cardiopulmonary changes during cemented hemiarthroplasty. J Bone Joint Surg Br.1995 May; 77(3):456-9.
150. Pitto RP, Hamer H, Fabiani R, et al. Prophylaxis against fat and bone-marrow embolism during total hip arthroplasty reduces the incidence of postoperative deep-vein thrombosis:A controlled, randomized clinical trial. J Bone Joint Surg Am.2002 Jan;84-A(1):39-48.
151. Bishop NE, Ferguson S, Tepic S. Porosity reduction in bone cement at the cement-stem interface. J Bone Joint Surg Br.1996 May; 78(3):349-56.
152. Dall DM, Miles AW, Juby G. Accelerated polymerization of acrylic bone cement using preheated implants. Clin Orthop.1986 Oct; 211:148-50.
153.Iesaka K, Jaffe WL, Kummer FJ. Effects of preheating of hip prostheses on the stem-cement interface. J Bone Joint Surg Am.2003 Mar; 85-A (3):421-7.
154. Parks ML, Walsh HA, Salvati EA, et al. Effect of increasing temperature on the properties of four bone cements. Clin Orthop.1998 Oct; 355:238-48.
155. Viscusi ER, Martin G, Hartrick CT, et al. Forty-eight hours of postoperative pain relief after total hip arthroplasty with a novel, extended-release epidural morphine formulation. Anesthesiology.2005 May; 102(5):1014-22.
156.Pagnani MJ, Pellicci PM, Salvati EA. Effect of aspirin on heterotopic ossification after total hip arthroplasty in men who have osteoarthrosis. J Bone Joint Surg Am.1991 Jul; 73(6):924-9.
157. Bek D, Beksac B, Gonzalez Della Valle A, et al. Aspirin decreases the prevalence and severity of heterotopic ossification after 1-stage bilateral total hip arthroplasty for osteoarthrosis. J Arthroplasty.2009 Feb; 24(2):226-32.
158. Shepard M, Mills C. Fatal pulmonary embolism following hip and knee replacement. A study of 2153 cases using routine mechanical prophylaxis and selective chemoprophylaxis. Hip Int.2006; 16(1):53-6.
159. Blom A, Pattison G, Whitehouse S, et al. Early death following primary total hip arthroplasty:1,727 procedures with mechanical thrombo-prophylaxis. Acta Orthop.2006 Jun;77(3):347-50.
160. D'Andrea G, D'Ambrosio RL, Di Perna P, et al. A polymorphism in the:VKORC1 gene is associated with an interindividual variability in the dose-anticoagulant effect of warfarin. Blood.2005 Jan 15; 105(2):645-9.
161. Kohnke H, Sorlin K, Granath G, et al. Warfarin dose related to apolipoprotein E (APOE) genotype. Eur J Clin Pharmacol.2005 Jul; 61(5-6):381-8.
162. Kosaki K, Yamaghishi C, Sato R, et al.1173C>T polymorphism in VKORC1 modulates the required warfarin dose. Pediatr Cardiol.2006 Nov-Dec; 27(6):685-8.
163. Salvati EA, Lachiewicz P. Thromboembolism following total hip-replacement arthroplasty. The efficacy of dextran-aspirin and dextran-warfarin in prophylaxis. J Bone Joint Surg Am.1976 Oct; 58(7):921-5.
164. Gonzalez Della Valle A, Salonia Ruzo P, Salvati EA. Warfarin-associated intracapsular hemorrhage causing an acutely painful total hip arthroplasty:A rare complication of prolonged anticoagulant therapy. J Arthroplasty.2000 Aug; 15(5):668-70.
165.Rosove MH, Grody WW. Should we be applying warfarin pharmacogenetics to clinical practice? no, not now. Ann Intern Med.2009 Aug 18; 151(4):270,3, W95.
166.Harm CL, Streiff MB. The role of vena caval filters in the management of venous thromboembolism. Blood Rev.2005 Jul; 19(4):179-202.
167. Francis CW, Berkowitz SD, Comp PC, et al. Comparison of ximelagatran with warfarin for the prevention of venous thromboembolism after total knee replacement. N Engl J Med.2003 Nov 30; 349(18):1703-12.
168. W. CC,Jr, Collis DK, Paulson R, et al. Comparison of enoxaparin and warfarin for the prevention of venous thromboembolic disease after total hip arthroplasty. evaluation during hospitalization and three months after discharge. J Bone Joint Surg Am.1999 Jul; 81(7):932-40.
169. Hull R, Raskob G, Pineo G, et al. A comparison of subcutaneous low-molecular-weight heparin with warfarin sodium for prophylaxis against deep-vein thrombosis after hip or knee implantation. N Engl J Med.1993 Nov 4; 329(19):1370-6.
170. Hull RD, Pineo GF, Francis C, et al. Low-molecular-weight heparin prophylaxis using dalteparin in close proximity to surgery vs warfarin in hip arthroplasty patients:A double-blind, randomized comparison. The North American fragmin trial investigators. Arch Intern Med.2000 Jul 24; 160(14):2199-207.
171. Warkentin TE, Greinacher A. Heparin-induced thrombocytopenia:Recognition, treatment, and prevention:The seventh ACCP conference on antithrombotic and thrombolytic therapy. Chest.2004 Sep; 126(3 Suppl):311S-37S.
172. Lieberman JR, Huo MM, Hanway J, et al. The prevalence of deep venous thrombosis after total hip arthroplasty with hypotensive epidural anesthesia. J Bone Joint Surg Am.1994 Mar; 76(3):341-8.
173.Leclerc JR, Gent M, Hirsh J, et al. The incidence of symptomatic venous thromboembolism after enoxaparin prophylaxis in lower extremity arthroplasty: A cohort study of 1,984 patients. Canadian collaborative group. Chest.1998 Aug; 114(2 Suppl Evidence):115S-8S.
174. Lotke PA, Palevsky H, Keenan AM, et al. Aspirin and warfarin for thromboembolic disease after total joint arthroplasty. Clin Orthop.1996 Mar; 324:251-8.
175. Warwick D, Harrison J, Glew D, et al. Comparison of the use of a foot pump with the use of low-molecular-weight heparin for the prevention of deep-vein thrombosis after total hip replacement. A prospective, randomized trial. J Bone Joint Surg Am.1998 Aug; 80(8):1158-66.
176. Parry M, Wylde V, Blom AW. Ninety-day mortality after elective total hip replacement:1549 patients using aspirin as a thromboprophylactic agent. J Bone Joint Surg Br.2008 Mar; 90(3):306-7.
177. Bozic KJ, Vail TP, Pekow PS, et al. Does aspirin have a role in venous thromboembolism prophylaxis in total knee arthroplasty patients? J Arthroplasty. 2009 Aug 11
178. Callaghan JJ, Dorr LD, and Engh GA, et al. Prophylaxis for thromboembolic disease:recommendations from the American College of Chest Physicians-are they appropriate for orthopaedic surgery? J Arthroplasty 2005; 20:273
179. American Academy of Orthopaedic Surgeons clinical guideline on prevention of symptomatic pulmonary embolism in patients undergoing total hip or knee arthroplasty. Available at http://www.aaos.org/Research/guidelines/guide.asp, 2007.
180. Eikelboom JW, Quinlan DJ, Douketis JD. Extended-duration prophylaxis against venous thromboembolism after total hip or knee replacement:a meta-analysis of the randomised trials. Lancet 2001; 358(9275):9-15.
181. Virchow R. Neuer fall von todlicher emboli der lungenarterie. Arch Pathol Anat. 1856; 10:225-8.2008。 3(28):54-55.
182 Falck-Ytter Y, Francis CW, Johanson NA, et al; American College of Chest Physicians:Prevention of VTE in orthopedic surgery patients:Antithrombotic Therapy and Prevention of Thrombosis,9th ed. American College of Chest Physicians Evidence-BasedClinical Practice Guidelines. Chest 2012; 141(2 suppl):e278S-e325S
183 Mont MA, Jacobs JJ:AAOS clinical practice guideline:Preventing venous thromboembolic disease in patients undergoing elective hip and knee arthroplasty. J Am Acad Orthop Surg 2011;19(12):777-778.
184. Lieberman J R:The new AAOS clinical practice guidelines on venous thromboembolic prophylaxis:How to adapt them to your practice. J Am Acad Orthop Surg 2011;19(12):717-721.
185. Walsh JJ,Bonnar J,Wright FW. A study of pulmonary embolism and deep leg vein thrombosis after major gynecologic surgery using labeled fribinogen-phlegbograpgy and lung scanning.J Obstet Gynecol Br Commonw,1974,81:311-316
186.Clarke-Pearson DL,Jelovesk FR,Creasman WT.Thromboembolism complicating surgery for cervical and uterine malignancy:incidence,risk factors, and prophylaxis.Obstet Gynecol,1983,61:87-94.
187.Goldhaber SE.Epidemiology of pulmonary embolism and deep vein-thrombosis. In:Bloom Al, Forbes CD, Thomas DP, eds.Haemostasis and thrombosis. London:Churchill,1994,1327
188.Thomas DP. Pathogenesis of venous thrombosis. In:Bloom Al, Fobes CD,Thomas DP, eds.Haemostasis and thrombosis. London:Churchill,1994,1335
1898. Allaart CF,Briei E.Familial venous thrombophilia. In:Bloom AL,Forbes CD,Thomas DP, eds. Haemostasis and thrombosis. London:Churchill, 1994,1349
190. Begamini TM,Richardson JD.The surgical implications of prinary hypercoagulation status.J Ky Med Assoc,1997,2:67-72
191. Bhatia M, Moochhala S. Role of inflammatory mediators in the pathophysiology of acute respiratory distress syndrome. J Pathol.2004;202(2):145-156
192. der C, Eichelbr?nner O, Roewer N. Are IL-6, IL-10 and PCT plasma concentrations reliable for outcome prediction in severe sepsis? A comparison with APACHE III and SAPS II. Inflamm Res.2004;53(4):158-163.
193.C erm ak J, K ey N S, B ach RR, et a 1. C-react ive pro tein induces hum an peripheral b lood m onocy tes to synthesiz e tissu e factor. Blood,1993; 82(2):513-520
194.马骊；任凤霞；张林.全髋关节置换后血清炎性因子表达及深静脉血栓形成57例分析.中国组织工程研究与临床康复.2009,1；22：
195. Fox EA, K ahn SR. T he relat ionship betw een inf lamm ation and ven ou s throm bos is. A system at ic rev iew of clin ical stud ies. T hrom b H aem os,t 2005; 94(2):362-365
196.杨林,祁光裕,李艳姿.C-反应蛋白与急性下肢深静脉血栓症反应的研究.中国现代普通外科进展,2006,10(5)：398-400
197. Folsom AR, L utsey PL, A stor BC, et a 1. C-react ive p ro tein and venous th rom boem bo lism. A prospective inv est igation in the ARICcohor.t Throm b H aem o s,t 2009; 102(4):615-619
198. No rdenho lz KE, M itch ellAM, K line JA. D irect com parison of the diagnost ic accuracy o f fifty protein b io log icalm arkers of pulmonary emboism for use in the em ergency department A cad Em erg M ed,2008; 15(9):795-799
199.Roumen-K1 appe EM, den H eijer M, van Uum SH, et al. Inflammat ory response in th e acut e phase of deep vein thrombosis [J]. J Vase S urg,2002; 35(4):701-706.
200.Thomas EA,Cobby MJ,Phys DE, et al. Liquid crystal thermography and C-recative protein in the detection of deep venous thrombosis.BMJ 1989;299:951-2
200. Bucek RA, Reit er M, Quehenberger P, et al. C-react ive p rotein in th e diagnosis of deep vein thr om bosis [J]. Br JH aemat ol,2002; 119(2):385-389.
201. Krieg er E, van Der L oo B, Amann-Vest i BR, et al. C-reactive prot ein and r ed cell aggregat ion cor relat e w ith 1 at e venousfunct ion aft er acu te deep venous thrombosi s [J]. J VascSu rg,2004; 40(4):644-649.
1. Geerts WH, Pineo GF, Heit JA, et al:Prevention of venous thromboembolism:The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 2004; 126(3 suppl): 338S-400S
2 Greets WH, Heit JA, Clagett GP, et al Prevention of venous thromboembolism.Chest.2001; 19(1 Suppl):132S-175S.
3 American Academy of Orthopaedic Surgeons clinical guideline on prevention of symptomatic pulmonary embolism in patients undergoing total hip or knee arthroplasty. Available at http://www.aaos.org/Research/guidelines/guide.asp,2007.
4 Greets WH,Bergqvist D,Pineo GF, et al.Prevention of venous thromboembolism:American College of Chest Physicians evidence-based clinical pratice guidelines(8th edition). Chest 2008,133,381S-453S
5 Trousseau A. Lectures on clinical medicine delivered at the Hotel-Dieu ParisLondon:New Sydenham Society; 1865. p228-332.
6Stamatakis JD, Kakkar VV, Sager S, Lawrence D, Naim D, Bentley PG:Femoral vein thrombosis and total hip replacement. BMJ 1977;2:223-225.
7 Binns M, Pho R:Femoral vein occlusion during hip arthroplasty. Clin Orthop Relat Res 1990;255:168-172.
8 Bottner F.Sculco TP:Nonpharmacologic thromboembolic prophylaxis in total knee arthroplasty.Clin Orthop Relat Res,2001,392:249-256
9 Arcangelo, V. P., & Peterson, A. M. (2006). Pharmacotherapeutics for advanced practice:A practical approach (2nd ed.). Philadelphia:Lippincott Williams & Wilkins.
10 Morris CD,Creevy WS,Einbom TA,et al. Pulmonary dietress and thromboembolic comditions affecting orthopaedic pratice,Chapter 12 Buckwalter JA,Einborn TA.Simon SR(eds):Orthpaedic Basic Science:Biology and the Biomechanics of the Musculoskeletal Symtem,2nd. Rosemont,IL,American Academy of Orthopaedi Surgeons,2000
11Planes A, Vochelle N, Fagola M. Total hip replacement and deep vein thrombosis. A venographic and necropsy study. J Bone Joint Surg Br.1990;72:9-13.
12. Arcelus JI, Caprini JA, Traverso CI. Venous thromboembolism after hospital discharge. Semin Thromb Hemost.1993; 19 Suppl 1:142-6.
13 Johnson R, Green JR, Charnley J. Pulmonary embolism and its prophylaxis following the Charnley total hip replacement. Clin Orthop Relat Res.1977;127:123-132.
14 Prevention of venous thrombosis and pulmonary embolism:NIH Consensus Development. JAMA 1986; 256:744-799
15Lieberman JR, Geerts WH. Prevention of venous thromboembolism after total hip and knee arthroplasty. J Bone Joint Surg Am.1994;76:1239-50.
16 Clagett GP, Anderson FA Jr, Levine MN, Salzman EW, Wheeler HB. Prevention of venous thromboembolism. Chest.1992;102(4 Suppl):391S-407S
17 Murray, DW,Britton, AR,Bulstrode, CJ:Thromboprophylaxis and death after total hip replacement. J. Bone and Joint Surg.,1996; 78-B (6):863-870,
18. Fender D, Harper WM, Thompson JR, Gregg PJ. Mortality and fatal pulmonary embolism after primary total hip replacement:results from a regional hip register. J Bone Joint Surg [Br] 1997; 79-B:896-9
19. Gonzalez Della Valle A, Serota A, Go G, et al. Venous thromboembolism is rare with a multimodal prophylaxis protocol after total hip arthropasty. Clin Orthop 2006; 444:146-53.
20. Cusick LA, Beverland DE. The incidence of fatal pulmonary embolism after primary hip and knee replacement in a consecutive series of 4253 patients. J Bone Joint Surg Br.2009 May; 91(5):645-8
21 Rodgers A, Walker N, Schug S, et al. Reduction of postoperative mortality and morbidity with epidural or spinal anesthesia:results from overview of randomized trials. BMJ 2000; 321:1493.
22 Davis F.M; Laurenson V.G; Gillespie W.J, et al. Deep vein thrombosis after total hip replacement. A comparison between spinal and general anesthesia. J Bone and Joint Surg, 1989,71-B (2):181-185
23 Modig J, Borg T, Karisrom G, et al. Thromboembolism after total hip replacement:role of epidural and general aensthesia. Anesth and Anal,1983,62:174-180
24 Rodgers A, Walker N, Schug S, et al:Reduction of postoperative mortality and morbidity with epidural or spinal anesthesia:Results from overview of randomized trials. BMJ 2000; 32125 Bading B, Blank S, Sculco TP, Pickering TG, Sharrock NE:Augmentation of calf blood flow by epinephrine infusion during lumbar epidural anesthesia. Anesth Analg 1994; 78:1119-1124.
26 Eroglu A, Uzunlar H, Erciyes N. Comparison of hypotensive epidural anesthesia and hypotensive total intravenous anesthesia on intraoperative blood loss during total hip replacement. Journal of Clinical Anesthesia 200517,420-425
27 Sharrock NE, Mineo R, Urquhart B, Salvati EA. The effect of two levels of hypotension on intraoperative blood loss during total hip arthroplasty performed under lumbar epidural anesthesia. Anesth Analg.1993; 76:580-584.
28 Lieberman JR, Huo MM, Hanway J, Salvati EA, Sculco TP, Sharrock NE. The prevalence of deep venous thrombosis after total hip arthroplasty with hypotensive epidural anesthesia. J Bone Joint Surg Am.1994; 76:341-348
29 Westrich GH, Farrell C, Bono JV, Ranawat CS, Salvati EA, Sculco TP. The incidence of venous thromboembolism after total hip arthroplasty:a specific hypotensive epidural anesthesia protocol. J Arthroplasty.1999; 14:456-463.
30 Sharrock NE,Bading B,Mineo R,et al. Deliberate hypotensive epidural anesthesia for patients with normal and low cardiac output. Anesth Analg 1994; 79:899-904
31 Williams-Russo P, Sharrock NE, Mattis S, Szatrowski TP, Charlson ME. Cognitive effects after epidural vs general anesthesia in older adults:a randomized trial. JAMA.1995; 274:44-50
32 Gardner AM, Fox RH:The venous foot pump:Influence on tissue perfusion and prevention of venous thrombosis. Ann Rheum Dis 1992; 51:1173-1178
33 Dai G, Gertler JP, Kamm RD:The effects of external compression on venous blood flow and tissue deformation in the lower leg. J Biomech Eng 1999; 121:557-564.
34 Westrich GH, Specht LM, Sharrock NE, Sculco TP, Salvati EA,Pellicci PM, Trombley JF, Peterson M. Pneumatic compression hemodynamics in total hip arthroplasty. Clin Orthop Relat Res.2000; 372:180-191.
35 Ryan MG, Westrich GH, Potter HG, Sharrock N, Maun LM, Macaulay W, Katkin P, Sculco TP, Salvati EA. Effect of mechanical compression on the prevalence of proximal deep venous thrombosis as assessed by magnetic resonance venography. J Bone Joint Surg Am.2002; 84:1998-2004.
36 Lachiewicz PF, Soileau ES. Multimodal prophylaxis for THA with mechanical compression. Clin Orthop Relat Res.2006; 453:225-230
37. Froimson M, Murray TG, Fazekas AF. Venous Thromboembolic Disease Reduction with a Portable Pneumatic Compression Device. J Arthroplasty 2009,24:310-316
38 Bek D, Beksac B, Gonzalez Della Valle A, et al:Aspirin decrease the prevalence and severity of heterotopic ossification after 1-stage bilateral total hip arthroplasty for osteoarthrosisJ Arhtroplasy 2009,24:226-232
39 Pulmonary Embolism Prevention (PEP) Trial Collaborative Group. Prevention of pulmonary embolism and deep vein thrombosis with low dose aspirin:pulmonary embolism prevention (PEP) trial. Lancet 2000; 355(9212):1295-302.
40 Collaborative overview of randomized trials of antiplatelet therapy:Ⅲ. Reductionin venous thrombosis and pulmonary embolism by ant platelet prophylaxis among surgical and medical patients:Antiplatelet Trialists'Collaboration.BMJ 1994; 308:235-246.
41 Lotke PA, Lonner JH:The benefit of aspirin chemoprophylaxis for thromboembolism after total knee arthroplasty. Clin Orthop Relat Res 2006; 452:175-180.
42 Bozic K J. Vail T P, Pekow P S, et al. Does Aspirin Have a Role in Venous Thromboembolism Prophylaxis in Total Knee Arthroplasty Patients? J Arthroplasty 2009 Vol.00 No.01-8
43 Eikelboom JW, Quinlan DJ, Douketis JD. Extended-duration prophylaxis against venous thromboembolism after total hip or knee replacement:a meta-analysis of the randomised trials. Lancet 2001; 358(9275):9-15.
44 Colwell CW Jr, Collis DK, Paulson R, et al. Comparison of enoxaparin and warfarin for the prevention of venous thromboembolic disease after total hip arthroplasty. Evaluation during hospitalization and three months after discharge. J Bone Joint Surg Am 1999; 81(7):932-40.
45 Sharrock NE, Gonzalez Della Valle A, Go G, Lyman S, Salvati EA. Potent anticoagulants are associated with a higher all-cause mortality rate after hip and knee arthroplasty. Clin Orthop Relat Res 2008; 466:714-21
46 Neviaser A S., Chang C, Lyman S,et al High Incidence of Complications From Enoxaparin Treatment After Arthroplasty. Clin Orthop Relat Res 2010; 468:115-119
47 Lieberman J R, John W, Frederick D, et al. The Efficacy of Prophylaxis with Low-Dose Warfarin for Prevention of Pulmonary Embolism following Total Hip Arthroplasty. J Bone Joint Surg [Am] 1997; 79-A; 319-25
48 Pellegrini VD Jr. Warfarin prophylaxes for orthopaedic venous thromboembolicdisease. Instr Course Lect.2002; 51:491-8.
49. Pellegrini VD Jr, Donaldson CT, Farber DC, Lehman EB, Evarts CM. Prevention of readmission for venous thromboembolic disease after total hip arthroplasty. Clin Orthop Relat Res.2005; 441:56-62.
50. Pellegrini VD Jr, Donaldson CT, Farber DC, Lehman EB, Evarts CM. Prevention of readmission for venous thromboembolism after total knee arthroplasty. Clin Orthop Relat Res. 2006; 452:21-7.
51 Lieberman J R, Barnes CL, Lachiewicz P F., Hanssen A D., Clarke H D, Pellegrinit VD Jr. Venous Thromboembolism Debate in Joint Arthroplasty. J Bone Joint Surg Am.2009; 91:29-32.
52 Pendleton RC, PharmD WM, Wanner N, et al. A Safe, Effective, and Easy to Use Warfarin Initiation Dosing Nomogram for Post-Joint Arthroplasty Patients. J Arthroplasty 2010,25, 1,121-127
53 Harenberg J, Wehling M. Current and future prospects for anticoagulant therapy:inhibitors of factor Xa and factor IIa. Semin Thromb Hemost 2008; 34:39-57.
54 Lassen MR, Davidson BL, Gallus A, et al. The efficacyand safety of apixaban, an oral, direct factorXa inhibitor, as thromboprophylaxis in patientsfollowing total knee replacement. J Thromb Haemost 2007; 5(12):2368-75.
55 Lassen MR, Raskob GE, Gallus A, et al. T Apixaban or Enoxaparin forThromboprophylaxis after Knee Replacement. N Engl J Med 2009; 361:594-604.
56 Kakkar AK, Brenner B, Dahl OE, et al. Extended duration rivaroxaban versus short-term enoxaparin forthe prevention of venous thromboembolism after totalhip arthroplasty:a double-blind, randomised controlled trial. Lancet 2008; 372:31-39.
57 Lazo-Langner A, Rodger MA, Wells PS. Lessonsfrom ximelagatran. Issues for future studies evaluating new oral direct thrombin inhibitors for venous thromboembolism prophylaxis in orthopedic surgery. Clin Appl Thromb Hemost, in press.
58. Eriksson BI, Dahl OE, Buller HR, et al. A new oral direct thrombin inhibitor, dabigatran etexilate, compared with enoxaparin for prevention of thromboembolic events following total hip or knee replacement:the BISTRO II randomized trial. J Thromb Haemost 2005; 3(1):103-11.
59. Eriksson BI, Dahl OE, Ahnfelt L, et al. Dose escalating safety study of a new oral direct thrombin inhibitor, dabigatran etexilate, in patients undergoing total hip replacement:BISTRO I. J Thromb Haemost 2004;2(9):1573-80.
60 Bae H, Westrich GH, Sculco TP, Salvati EA, Reich LM. The effect of preoperative donation of autologous blood on deep-vein thrombosis after total hip arthroplasty. J Bone Joint Surg Br. 2001; 83:676-679.
61 Sharrock N, Go G, Mayman D, Sculco TP. Decreases in pulmonary artery oxygen saturation during total hip arthroplasty:variations using two leg positioning techniques. J Arthroplasty. 2005; 20:499-502.
62 Salvati EA, Gonzalez Della Valle A. Thromboembolism following total hip replacement. J Long Term Eff Med Implants.2003; 13:325-340.
63. Salvati EA, Gonzalez Della Valle A, Westrich GH, Rana AJ, Specht L, Weksler BB, Wang P, Glueck CJ. The John Charnley Award:heritable Thrombophilia and Development of Thromboembolic Disease after total hip arthroplasty. Clin Orthop Relat Res.2005; 441:40-55.
64. Salvati EA, Lachiewicz P. Thromboembolism following total hip replacement arthroplasty:the efficacy of dextran-aspirin and dextran-warfarin in prophylaxis. J Bone Joint Surg Am.1976; 58:921-925.
65. Salvati EA, Pellegrini VD Jr, Sharrock NE, Lotke PA, Murray DW, Potter H, Westrich GH. Recent advances in venous thromboembolic prophylaxis during and after total hip replacement. J Bone Joint Surg Am.2000; 82:252-270.
66 Sharrock NE, Go G, Harpel PC, Ranawat CS, Sculco TP, Salvati EA. The John Charnley Award:thrombogenesis during total hip arthroplasty. Clin Orthop Relat Res.1995; 319:16-2
67 Eduardo A.Salvati, Nigel F.Sharrock, Geoffrey Westrich, et al. The 2007 ABJS Nicolas Andry Award:three decades of linical, basic, and applied research on thromboembolic disease after THA. Clin Orthop Relat Res 2007; 459:246-254
68 Gonzalez Della Valle A, Reynoso FJ, Ari JB, Salvati E. The multimodal approach for the prevention of thromboembolic disease after total joint arthroplasty. Seminars in Arthroplasty 2009,20,4:241-250
1. Geerts WH, Pineo GF, Heit JA, et al:Prevention of venous thromboembolism:The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 2004; 126(3 suppl):338S-400S
2. Greets WH, Heit JA, Clagett GP, et al Prevention of venous thromboembolism.Chest.2001; 19(1 Suppl):132S-175S.
3。 revention of venous thrombosis and pulmonary embolism:NIH Consensus Development. JAMA 1986; 256:744-799
4。 einmann, E, Salzman, E. W:Deep-vein thrombosis. New England J. Med.,1994 331:1630-1641
5。 arwick D, Williams MH, Bannister GC. Death and thromboembolic disease after total hip replacement a series of 1162 cases with no routine chemical prophylaxis. J Bone Joint Surg Br 1995; 77-B (1):6-10
6. Geerts WH, Bergqvist D, Pineo GF, et al. Prevention of venous thromboembolism: American college of chest physicians evidence-based clinical practice guidelines. 8th edition. Chest 2008; 133(Suppl 6):381S-453
7. Murray, D. W.; Britton, A. R.; and Bulstrode, C. J. K.:Thromboprophylaxis and death after total hip replacement. J. Bone and Joint Surg.,1996; 78-B (6):863-870,
8. Fenders D, Harper WM, Thompson JR, Gregg PJ. Mortality and fatal pulmonary embolism after primary total hip replacement:results from a regional hip register. J Bone Joint Surg [Br] 1997; 79-B:896-9
9. Gonzalez Della Valle A, Serota A, Go G, et al. Venous thromboembolism is rare with a multimodal prophylaxis protocol after total hip arthropasty. Clin Orthop 2006; 444:146-53.
10. Cusick LA, Beverland DE. The incidence of fatal pulmonary embolism after primary hip and knee replacement in a consecutive series of 4253 patients. J Bone Joint Surg Br.2009 May; 91(5):645-8
11. Rodgers A, Walker N, Schug S, et al. Reduction of postoperative mortality and morbidity with epidural or spinal anesthesia:results from overview of randomized trials. BMJ 2000; 321:1493.
12. Lawrence D.Dorr, Vlad Genlelman, Aditya V.Maheshwari, et al. Multomodal thromboprophylaxis for total hip and knee arthroplasy baced on risk assessment J Bone Joint Surg Am.2007; 89:2648-57
13. Shaieb MD, Watson BN, Atkinson RE. Bleeding complication with enoxaparin for deep venous thrombosis prophylaxis. J Arthroplasty 1999; 14:432-438
14. Beksac BP, Gonzalez Della Valle A, Salvati EA. Acute sciatic nerve palsy as a delayed complication of low-molecular-weight heparin prophylaxis after total hip arthroplasty.Am J Orthop 2009,38:E20-E30.
15. Pellegrini VD Jr, Donaldson CT, Farber DC, ET AL.The John Charnley Award: Prevention of readmission for venous thromboembolic disease after total hip arthroplasty.Clin Orthop Relat Res 2005,441:56-62.
16. Heit JA,O'fallon WM, Petterson TM,et al. Relative impact of risk factors for deep vein thrombosis and pulmonary embolism:a population-based study. Arch Intern Med.2002; 162:1245-1248
17. Thodiyil PA, Kakkar AK.Variation in relative risk of venous thromboembolism in different cancers. Thromb Haemost.2002; 87:1076-1077
18. Murin S, Romano PS, White RH.Comparison of outcomes after hospitalization for deep venous thrombosis or pulmonary embolism. Thromb Haemost.2002; 88:407-414
19. Fisher B,Costantino JP,Wickerhan DL,et al.Tamoxifen for prevention of breast cancenreport of the National Surgical Adjuvant Breast and Bowel Project P-1 Study.J Natl Cancer Inst.1998;90:1371-1388
20. Cummings SR, Eckert S, Krueger KA, et al. The effect of raloxifene on risk of breast cancer in postmenopausal women:results from the MORE randomized trial. JAMA.1999; 281:2189-2197
21. Gomes MP, Deitcher SR. Risk of venous thromboembolic disease associated with hormonal contraceptives and hormone reolacement therapy:a clinical review.Arch Intern Med.2004; 164:1965-1976
22. Rosendaal FR, Helmerhorst FM, Vandenbroucke JP. Female hormones and thrombosis. Arterioscler Thromb Vasc Biol.2002; 22:201-210
23. Grady D,Wenger NK,Herrington D,et al. Postmenopausal hormone therapy increases risk for venous thrombo-embolic disease:the Heart and Estrogen/progestin Replacement Study. Ann Intern Med.2000; 132:689-696
24. Mantilla CB,Horlocker TT,Schroeder DR,et al. Risk factors for clinically relavent pulmonary embolism and deep venous thrombosis in patients undergoing primary hip or knee arthroplasty. Anesthesiology 2003; 99:552-560
25. Lowe GD,Haverkate F,Thompson SG,et al. Prediction of deep vein thrombosis after elective replacemehe ECAT DVTnt hip surgery by preoperative clinical and haemostatic variables:the ECAT DVT Study:European Concerted Action on Thrombosis.Thromb Haemost.1999; 81:879-886
26. Davis F.M; Laurenson V.G; Gillespie W.J, et al. Deep vein thrombosis after total hip replacement. A comparison between spinal and general anesthesia. J Bone and Joint Surg,1989,71-B (2):181-185
27. Modig J, Borg T, Karisrom G, et al. Thromboembolism after total hip replacement:role of epidural and general aensthesia. Anesth and Anal,1983, 62:174-180
28. Bading B, Blank S, Sculco TP, Pickering TG, Sharrock NE:Augmentation of calf blood flow by epinephrine infusion during lumbar epidural anesthesia.Anesth Analg 1994; 78:1119-1124.
29. Sharrock NE, Mineo R, Urquhart B, Salvati EA. The effect of two levels of hypotension on intraoperative blood loss during total hip arthroplasty performed under lumbar epidural anesthesia. Anesth Analg.1993; 76:580-584.
30. Lieberman JR, Huo MM, Hanway J, Salvati EA, Sculco TP, Sharrock NE. The prevalence of deep venous thrombosis after total hip arthroplasty with hypotensive epidural anesthesia. J Bone Joint Surg Am.1994; 76:341-348
31. Westrich GH, Farrell C, Bono JV, Ranawat CS, Salvati EA, Sculco TP. The incidence of venous thromboembolism after total hip arthroplasty:a specific hypotensive epidural anesthesia protocol. J Arthroplasty.1999; 14:456-463
32. Sharrock NE,Bading B,Mineo R,et al. Deliberate hypotensive epidural anesthesia for patients with normal and low cardiac output. Anesth Analg 1994; 79:899-904
33. Sharrock NE, Beksac B, Flynn E, Go G, Gonzalez Della Valle A.Hypotensive epidural anaesthesia in patients with preoperative renal dysfunction undergoing total hip replacement. Br J Anaesth.2006; 96:207-212.
34. Williams-Russo P, Sharrock NE, Mattis S, Szatrowski TP, Charlson ME. Cognitive effects after epidural vs general anesthesia in older adults:a randomized trial. JAMA.1995; 274:44-50
35. Knight MTN, Dawson R:Effect of intermittent compression of the arms on deep venous thrombosis of the leg. Lancet 1976; 2:1265-1268
36. Macaulay W,Westrich G,Sharrock N,et al. Effect of Pneumatic compression on frbrinolysis after total hip arthroplasty. Clin Orthop Relat Res.2002; 399; 168-176
37. Westrich GH, Specht LM, Sharrock NE, et al.Peterson M.'Pneumatic compression hemodynamics in total hip arthroplasty. Clin Orthop Relat Res.2000; 372:180-191
38. Lachiewicz PF, Soileau ES. Multimodal prophylaxis for THA with mechanical compression. Clin Orthop Relat Res.2006; 453:225-230.
39. Ryan MG, Westrich GH, Potter HG. Effect of mechanicalcompression on the prevalence of proximal deep venous thrombosisas assessed by magnetic resonance venography. J Bone JointSurg Am.2002; 84:1998-2004.
40. Froimson M, Murray TG, Fazekas AF. Venous Thromboembolic Disease Reduction with a Portable Pneumatic Compression Device. J Arthroplasty 2009, 24:310-316
41. allaghan JJ, Dorr LD, and Engh GA, et al. Prophylaxis for thromboembolic disease:recommendations from the American College of Chest Physicians-are they appropriate for orthopaedic surgery? J Arthroplasty 2005; 20:273
42. American Academy of Orthopaedic Surgeons clinical guideline on prevention of symptomatic pulmonary embolism in patients undergoing total hip or knee arthroplasty. Available at http://www.aaos.org/Research/guidelines/guide.asp, 2007.
43. Bek D,Beksac B,Gonzalez Della Valle A,et al:Aspirin decrease the prevalence and severity of heterotopic ossification after 1-stage bilateral total hip arthroplasty for osteoarthrosis.J Arhtroplasy 2009,24:226-232
44. Eikelboom JW, Karthikeyan G, Fagel N. American Association of Orthopedic Surgeons and American College of Chest Physicians Guidelines for Venous Thromboembolism Prevention in Hip and Knee Arthroplasty Differ What Are the Implications for Clinicians and Patients? Chest.2009 Feb; 135(2):513-20
45. Markel DC,York S,Liston MJ,et al. Venous thromboembolism management by American Association of Hip and Knee Surgeons. J Arthroplasty 2010,25,1:3-9
46. Pulmonary Embolism Prevention (PEP) Trials Collaborative Group. Prevention of pulmonary embolism and deep vein thrombosis with low dose aspirin: pulmonary embolism prevention (PEP) trial. Lancet 2000; 355(9212):1295-302.
47. Collaborative overview of randomized trials of antiplatelet therapy:Ⅲ. Reduction in venous thrombosis and pulmonary embolism by ant platelet prophylaxis among surgical and medical patients:Antiplatelet Trialists Collaboration.BMJ 1994; 308:235-246.
48. Lotke PA, Lonner JH:The benefit of aspirin chemoprophylaxis for thromboembolism after total knee arthroplasty. Clin Orthop Relat Res 2006; 452: 175-180.
49. Eikelboom JW, Quinlan DJ, Douketis JD. Extended-duration prophylaxis against venous thromboembolism after total hip or knee replacement:a meta-analysis of the randomised trials. Lancet 2001; 358(9275):9-15.
50. Col well CW Jr, Collis DK, Paulson R, et al. Comparison of enoxaparin and warfarin for the prevention of venous thromboembolic disease after total hip arthroplasty. Evaluation during hospitalization and three months after discharge. J Bone Joint Surg Am 1999; 81(7):932-40.
51. rancis CW, Berkowitz SD, Comp PC, et al. Comparison of ximelagat-ran with warfarin for the prevention of venous thromboembolism after total knee replacement. N Engl J Med 2003,349:1703-1712
52. Hull RD,Pineo GF,Francis C,et al.Timing of intial administration of low-molecular-weight heparin prophylaxis using dalteparin in close proximity to surgery vs warfarin in hip arthroplasty patients:A double-blind,randomized comparison.The North American Fragmin Trial Investigators.Arch Intern Med 2000,160:2199-2207
53. Callaghan JJ, Dorr LD, Engh GA, et al:prophylaxis for thromboembolic disease. J Arthroplasty 2005,20:273-274
54= Freedman KB, Brookenthal KR, Fitzgerald RH, et al:A meta-analysis of thromboembolic prophylaxis following elective total hip arthroplasty.J Bone Joint Surg Am 2000, A82:929-938
55. Lieberman J R, John W, Frederick D, et al. The Efficacy of Prophylaxis with Low-Dose Warfarin for Prevention of Pulmonary Embolism following Total Hip Arthroplasty. J Bone Joint Surg [Am] 1997; 79-A; 319-25
56. Francis CW, Pellegrini VD Jr, Totterman S, et al:Prevention of deep-vein thrombosis after total hip arthroplasty:Comparison of warfarin and dalteparin. J Bone Joint Surg Am 1997; 79:1365-1372.
57. Francis CW, Pellegrini VD Jr, MarderVJ, et al:Comparison of warfarin and external pneumatic compression inprevention of venous thrombosis aftertotal hip replacement. JAMA 1992; 267:2911-2915.
58. Pellegrini VD Jr. Warfarin prophylaxes for orthopaedic venous thromboembolic disease. Instr Course Lect.2002; 51:491-8.
59. Pellegrini VD Jr, Donaldson CT, Farber DC, Lehman EB, Evarts CM. Prevention of readmission for venous thromboembolic disease after total hip arthroplasty. Clin Orthop Relat Res.2005; 441:56-62.
60. Pellegrini VD Jr, Donaldson CT, Farber DC, Lehman EB, Evarts CM. Prevention of readmission for venous thromboembolism after total knee arthroplasty. Clin Orthop Relat Res.2006; 452:21-7.
61. Lieberman J R, Barnes CL, Lachiewicz P F., Hanssen A D., Clarke H D, Pellegrinit VD Jr. Venous Thromboembolism Debate in Joint Arthroplasty. J Bone Joint Surg Am.2009; 91:29-32.
62. Lassen MR, Davidson BL, Gallus A, et al. The efficacyand safety of apixaban, an oral, direct factorXa inhibitor, as thromboprophylaxis in patientsfollowing total knee replacement. J Thromb Haemost 2007; 5(12):2368-75.
63. Lassen MR, Raskob GE, Gallus A, et al. T Apixaban or Enoxaparin for Thromboprophylaxis after Knee Replacement. N Engl J Med 2009; 361:594-604.
64. Kakkar AK, Brenner B, Dahl OE, et al. Extended duration rivaroxaban versus short-term enoxaparin forthe prevention of venous thromboembolism after total hip arthroplasty:a double-blind, randomised controlled trial. Lancet 2008; 372:31-39.
65. Lazo-Langner A, Rodger MA, Wells PS. Lessonsfrom ximelagatran. Issues for future studies evaluating new oral direct thrombin inhibitors for venousthromboembolism prophylaxis in orthopedic surgery. Clin Appl Thromb Hemost, in press.
66. Bae H, Westrich GH, Sculco TP, Salvati EA, Reich LM. The effect of preoperative donation of autologous blood on deep-vein thrombosis after total hip arthroplasty. J Bone Joint Surg Br.2001; 83:676-679.
67. Sharrock N, Go G, Mayman D, Sculco TP. Decreases in pulmonary artery oxygen saturation during total hip arthroplasty:variations using two leg positioning techniques. J Arthroplasty.2005; 20:499-502.
68. Salvati EA, Gonzalez Della Valle A. Thromboembolism following total hip replacement. J Long Term Eff Med Implants.2003; 13:325-340.
69. Salvati EA, Gonzalez Della Valle A, Westrich GH, Rana AJ, Specht L, Weksler BB, Wang P, Glueck CJ. The John Charnley Award:heritable Thrombophilia and Development of Thromboembolic Disease after total hip arthroplasty. Clin Orthop Relat Res.2005; 441:40-55.
70. Salvati EA, Lachiewicz P. Thromboembolism following total hip replacementarthroplasty:the efficacy of dextran-aspirin and dextran-warfarin in prophylaxis. J Bone Joint Surg Am.1976; 58:921-925.
71. Salvati EA, Pellegrini VD Jr, Sharrock NE, Lotke PA, Murray DW, Potter H, Westrich GH. Recent advances in venous thromboembolic prophylaxis during and after total hip replacement. J Bone Joint Surg Am.2000; 82:252-270.
72. Eduardo A.Salvati, Nigel F.Sharrock, Geoffrey Westrich, et al. The 2007 ABJS Nicolas Andry Award:three decades of linical,basic,and applied research on thromboembolic disease after THA. Clin Orthop Relat Res 2007; 459:246-254
73. Gonzalez Della Valle A, Reynoso FJ, Ari JB, Salvati E. The multimodal approach for the prevention of thromboembolic disease after total joint arthroplasty. Seminars in Arthroplasty 2009,20,4:241-250
2. Coventry MB, Beckenbaugh RD, Nolan DR, et al.2,012 total hip arthroplasties. A study of postoperative course and early complications. J Bone Joint Surg Am. 1974 Mar; 56(2):273-84.
3. DiGiovanni CW, Restrepo A, Gonzalez Della Valle AG, et al. The safety and efficacy of intraoperative heparin in total hip arthroplasty. Clin Orthop.2000 Oct; 379:178-85.
4. Salvati EA, Gonzalez Delia Valle A. Thromboembolism following total hip replacement. J Long Term Eff Med Implants.2003; 13(4):325-40.
5. Salvati E, Sharrock NE, Westrich G, et al. Nicholas andry award:Three decades of clinical, basic and applied research on thromboembolic disease after total hip arthroplasty. The rationale and clinical results of a multimodal prophylaxis protocol. Clin Orthop.2007; Jun;459:246-54
6. Mohr DN, Silverstein MD, Ilstrup DM, et al. Venous thromboembolism associated with hip and knee arthroplasty:Current prophylactic practices and outcomes. Mayo Clin Proc.1992 Sep; 67(9):861-70.
7. Warwick D, Williams MH, Bannister GC. Death and thromboembolic disease after total hip replacement. A series of 1162 cases with no routine chemical prophylaxis. J Bone Joint Surg Br.1995 Jan; 77(1):6-10.
8. Lieberman JR, Wollaeger J, Dorey F, et al. The efficacy of prophylaxis with low-dose warfarin for prevention of pulmonary embolism following total hip arthroplasty. J Bone Joint Surg Am.1997 Mar; 79(3):319-25.
9. Westrich GH, Farrell C, Bono JV, et al. The incidence of venous thromboembolism after total hip arthroplasty:A specific hypotensive epidural anesthesia protocol. J Arthroplasty.1999 Jun; 14(4):456-63.
10. Sarmiento A, Goswami AD. Thromboembolic prophylaxis with use of aspirin, exercise, and graded elastic stockings or intermittent compression devices in patients managed with total hip arthroplasty. J Bone Joint Surg Am.1999 Mar; 81(3):339-46.
11. Salvati EA, D. PV, Jr, Sharrock NE, et al. Recent advances in venous thromboembolic prophylaxis during and after total hip replacement. J Bone Joint Surg Am.2000 Feb; 82(2):252-70.
12. Phillips CB, Barrett JA, Losina E, et al. Incidence rates of dislocation, pulmonary embolism, and deep infection during the first six months after elective total hip replacement. J Bone Joint Surg Am.2003 Jan; 85-A(1):20-6.
13. Gonzalez Della Valle A, Serota A, Sorriaux G, et al. Venous thromboembolism is rare after total hip arthroplasty with a multimodal prophylaxis protocol. Clin Orthop.2006; 443:146-53.
14. Murray DW, Carr AJ, Bulstrode CJ. Pharmacological thromboprophylaxis and total hip replacement. J Bone Joint Surg Br.1995 Jan; 77(1):3-5.
15. Alejandro Gonzalez Della Valle;Francis Jeshira Reynoso;Judith Ben Ari;Eduardo Salvati;鲁宁.多重方法预防髋膝关节置换术后的血栓性疾病中华关节外科杂志(电子版)2011,5；2：53-57
16. Cusick LA, Beverland DE. The incidence of fatal pulmonary embolism after primary hip and knee replacement in a consecutive series of 4253 patients. J Bone Joint Surg Br.2009 May; 91(5):645-8.
17. Sachs RA, Smith JH, Kuney M, et al. Does anticoagulation do more harm than good:A comparison of patients treated without prophylaxis and patients treated with low-dose warfarin after total knee arthroplasty. J Arthroplasty.2003 Jun; 18(4):389-95.
18.Dhillon KS, Askander A, Doraismay S. Postoperative deep-vein thrombosis in Asian patients is not a rarity:a prospective study of 88 patients with no prophylaxis. J Bone Joint Surg Br.1996;78(3):427-430.
19 Kew J, Lee YL, Davey IC,et al. Deep vein thrombosis in elderly Hong Kong Chinese with hip fractures detected with compression ultrasound and Doppler imaging:incidence and effect of low molecular weight heparin. Arch Orthop Trauma Surg.1999; 119(3-4):156-158.
20.吕厚山,徐斌.人工关节置换术后下肢深静脉血栓形成[J].中华骨科杂志,1999,19(3)：155-156.
21.邱贵兴杨庆铭余楠生等-低分子肝素预防髋、膝关节手术后下肢深静脉血栓形成的多中心研究。中华骨科杂志.2006,12：819
22.壬玉琦,叶建荣.血管外科学治疗学[M].上海：上海科学技术出版社,2003,216-218.
23.唐孝明,裴福兴,沈彬.麻醉对人工全髋关节置换术后深静脉血栓形成的影响[J].骨与关节损伤杂志,2002,05(3).
24.臧学慧；查振刚；冯永洪；高立华；孙辉.全髋关节置换后早期并发深静脉血栓的多因素Logistic回归分析；-《中国组织工程研究与临床康复》-2010-04-23
25陆芸.码宗通,郭若霖.等.骨科创伤患者深静脉血栓危险因素的研究.中华骨科杂志,2007,27(9)：693—698.
26.曲洪雩,刘厶鹏.骨科深静脉血栓形成危险冈素及发病机制的研究进展[J].中国矫形外科杂志,2009.17(2)：110—112.
27.扬兴光,孙忠,王学谦,等.骨折术后深静脉栓塞的危险因素分析.天津医药,2010,38(6)：464—466.
28.韩伟峰,黄新天.殷敏毅.等.下肢深静脉血栓形成的临床流行病学研究.中华普通外科杂志,2009,24(1)：30一33.
29.Tai YF. An association between atherosclerosis and venous thrombosis. N Engl J Med.2003;349(4):401-402.
30.魏鹤新.骨科大手术前后深静脉血栓的预防[J].中国实用医药,
31.殷婷,王凌云.陈明莹.等.全髋置换术后深静脉血栓形成相关因素分析[J].中国煤炭工业医学,2002,5(11)：1103.
32.吕厚山,徐斌.人工髋关节置换术后下肢深静脉血栓形成[J].中华骨科杂志,2002.18(2)：55.
33.李进.骨科手术后深静脉血栓形成的预防分析[J].现代医药卫生,2007,4：521-522
34. Stein PD, Kayali F, Olson RE, et al. Pulmonary thromboembolism in American Indians and Alaskan natives. Arch Intern Med,2004, 164:1804.1806.
35杨刚,吕厚山,高健等.低分子肝素预防人工髋、膝关节置换术后下肢深静脉血栓形成的研究,中华外科杂志,2000,38,25-27
36.韦利芳.预防全懿关节置换术后下肢深静脉血栓形成的护理进展[J].中外健康文摘,2011,1
37.梁观宝,何伟东.磁治疗带预防髋膝关节术后下肢深静脉血栓形成[J].中国康复,2002,17(2)：90-91.
38.代杰,曹飞.疏血通注射液预防下肢人工关节簧换术后深静脉栓塞的应用[J].中国社区医师,2008,10(179)：56
39刘天盛,苏彬,王字强,等.活血通脉胶囊联合周期性充气加压预防髋部骨折手术后深静脉栓塞[J].武警医学院学报,2008,17(5)：415-419.
40.林守清.女性围绝经期激素治疗国内外近期临床应用进展[J].中国实用妇科与产科杂志,2006,01
41.宋琳琳.髋、膝关节矫形术和髋部骨折内固定术后病人下肢深静脉血栓形成的危险因素[J].中华麻醉学杂志,2008,3：205-207
42.张伯英.麻醉对DVT形成的影响[J].中华现代临床医学杂志,2004,2(8B)
43. Walsh JJ,Bonnar J,Wright FW. A study of pulmonary embolism and deep leg vein thrombosis after major gynecologic surgery using labeled fribinogen-phlegbograpgy and lung scanning.J Obstet Gynecol Br Commonw,1974,81:311-316
44. Clarke-Pearson DL,Jelovesk FR,Creasman WT.Thromboembolism complicating surgery for cervical and uterine malignancy:incidence,risk factors, and prophylaxis.Obstet Gynecol,1983,61:87-94.
45. Goldhaber SE.Epidemiology of pulmonary embolism and deep vein-thrombosis. In:Bloom Al, Forbes CD, Thomas DP, eds.Haemostasis and thrombosis. London:Churchill,1994,1327
46. Thomas DP. Pathogenesis of venous thrombosis. In:Bloom Al, Fobes CD,Thomas DP, eds.Haemostasis and thrombosis. London:Churchill,1994,1335
47 Allaart CF,Briei E.Familial venous thrombophilia. In:Bloom AL,Forbes CD,Thomas DP, eds. Haemostasis and thrombosis. London:Churchill, 1994,1349
48. Begamini TM,Richardson JD.The surgical implications of prinary hypercoagulation status.J Ky Med Assoc,1997,2:67-72
49. Salvati EA, Sharrock NE, Westrich G, et al. The 2007 ABJS nicolas andry award: Three decades of clinical, basic, and applied research on thromboembolic disease after THA:Rationale and clinical results of a multimodal prophylaxis protocol. Clinical orthopaedics and related research.2007 Jun; 459:246-54.
50. Sharrock NE, Gonzalez Della Valle A, Go G, et al. Potent anticoagulants are associated with a higher all-cause mortality rate after hip and knee arthroplasty. Clinical orthopaedics and related research.2008 Mar; 466(3):714-21.
51. Sharrock NE, Gonzalez Della Valle A, and Go G, et al. Reply to letter to editor: Potent anticoagulants are associated with a higher all-cause mortality rate after hip and knee arthroplasty. Clinical orthopaedics and related research.2008 Jun 4:234-236
52. Beksac B, Gonzalez Della Valle A, and Salvati EA. Thromboembolic disease after total hip arthroplasty:Who is at risk? Clin Orthop Relat Res.2006; 453:211-24.
53. Bae H, Westrich GH, Sculco TP, et al. The effect of preoperative donation of autologous blood on deep-vein thrombosis after total hip arthroplasty. J Bone Joint Surg Br.2001 Jul; 83(5):676-9.
54. Sharrock NE, Fischer G, Goss S, et al. The early recovery of cognitive function after total-hip replacement under hypotensive epidural anesthesia. Reg Anesth Pain Med.2005 Mar-Apr; 30(2):123-7.
55. Modig J. Beneficial effects on intraoperative and postoperative blood loss in total hip replacement when performed under lumbar epidural anesthesia. An explanatory study. Acta Chir Scand Suppl.1989; 550:95,100; discussion 100-3.
56. Davis FM, Laurenson VG, Gillespie WJ, et al. Deep vein thrombosis after total hip replacement. A comparison between spinal and general anaesthesia. J Bone Joint Surg Br.1989 Mar; 71(2):181-5.
57. Modig J, Borg T, Karlstrom G, et al. Thromboembolism after total hip replacement: Role of epidural and general anesthesia. Anesth Analg.1983 Feb; 62(2):174-80.
58. Wille-Jorgensen P, Christensen SW, Bjerg-Nielsen A, et al. Prevention of thromboembolism following elective hip surgery. The value of regional anesthesia and graded compression stockings. Clin Orthop.1989 Oct; 247:163-7.
59. Prins MH, Hirsh J. A comparison of general anesthesia and regional anesthesia as a risk factor for deep vein thrombosis following hip surgery:A critical review. Thromb Haemost.1990 Dec 28; 64(4):497-500.
60. Sharrock NE, Salvati EA. Hypotensive epidural anesthesia for total hip arthroplasty:A review. Acta Orthop Scand.1996 Feb; 67(1):91-107.
61. Sharrock NE, Cazan MG, Hargett MJ, et al. Changes in mortality after total hip and knee arthroplasty over a ten-year period. Anesth Analg.1995 Feb; 80(2):242-8.
62. Sharrock NE, Mineo R, Urquhart B, et al. The effect of two levels of hypotension on intraoperative blood loss during total hip arthroplasty performed under lumbar epidural anesthesia. Anesth Analg.1993 Mar; 76(3):580-4.
63. Sharrock NE, Go G, Harpel PC, et al. The john charnley award. Thrombogenesis during total hip arthroplasty. Clin Orthop.1995 Oct; 319:16-27.
64. Pitto RP, Koessler M, Draenert K. The john charnley award. prophylaxis of fat and bone marrow embolism in cemented total hip arthroplasty. Clin Orthop.1998 Oct; 355:23-34.
65. Sharrock N, Go G, Mayman D, et al. Decreases in pulmonary artery oxygen saturation during total hip arthroplasty. Variations using two leg positioning techniques. J Arthroplasty.2005; 20(4):499-502.
66. Hooker JA, Lachiewicz PF, Kelley SS. Efficacy of prophylaxis against thromboembolism with intermittent pneumatic compression after primary and revision total hip arthroplasty. J Bone Joint Surg Am.1999 May; 81(5):690-6.
67. Macaulay W, Westrich G, Sharrock N, et al. Effect of pneumatic compression on fibrinolysis after total hip arthroplasty. Clin Orthop.2002 Jun; 399:168-76.
68. Ryan MG, Westrich GH, Potter HG, et al. Effect of mechanical compression on the prevalence of proximal deep venous thrombosis as assessed by magnetic resonance venography. J Bone Joint Surg Am.2002 Nov; 84-A(11):1998-2004.
69. Westrich GH, Specht LM, Sharrock NE, et al. Pneumatic compression hemodynamics in total hip arthroplasty. Clin Orthop.2000 Mar; 372:180-91.
70. Markel DC, Urquhart B, Derkowska I, et al. Effect of epidural analgesia on venous blood flow after hip arthroplasty. Clin Orthop.1997 Jan; 334:168-74.
71. Prandoni P, Lensing AW, Prins MH, et al. Below-knee elastic compression stockings to prevent the post-thrombotic syndrome:A randomized, controlled trial. Ann Intern Med.2004 Aug 17; 141(4):249-56.
72. Geerts WH, Pineo GF, Heit JA, et al:Prevention of venous thromboembolism: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 2004; 126(3 suppl):338S-400S
73.Heit JA,O'fallon WM, Petterson TM,et al. Relative impact of risk factors for deep vein thrombosis and pulmonary embolism:a population-based study. Arch Intern Med.2002; 162:1245-1248
74. Thodiyil PA, Kakkar AK. Variation in relative risk of venous thromboembolism in different cancers. Thromb Haemost.2002; 87:1076-1077
75. Murin S, Romano PS, White RH.Comparison of outcomes after hospitalization for deep venous thrombosis or pulmonary embolism. Thromb Haemost.2002; 88:407-414
76. Fisher B,Costantino JP,Wickerhan DL,et al.Tamoxifen for prevention of breast cancer:report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study J Natl Cancer Inst.1998;90:1371-1388
77. Cummings SR, Eckert S, Krueger KA, et al. The effect of raloxifene on risk of breast cancer in postmenopausal women:results from the MORE randomized trial. JAMA.1999; 281:2189-2197
78. Gomes MP,Deitcher SR. Risk of venous thromboembolic disease associated with hormonal contraceptives and hormone reolacement therapy:a clinical review.Arch Intern Med.2004;164:1965-1976
79. Rosendaal FR, Helmerhorst FM, Vandenbroucke JP. Female hormones and thrombosis. Arterioscler Thromb Vase Biol.2002; 22:201-210
80. Grady D,Wenger NK,Herrington D,et al. Postmenopausal hormone therapy increases risk for venous thrombo-embolic disease:the Heart and Estrogen/progestin Replacement Study. Ann Intern Med.2000; 132:689-696
81. Mantilla CB,Horlocker TT,Schroeder DR,et al. Risk factors for clinically relavent pulmonary embolism and deep venous thrombosis in patients undergoing primary hip or knee arthroplasty. Anesthesiology 2003; 99:552-560
82. Lowe GD,Haverkate F,Thompson SG,et al. Prediction of deep vein thrombosis after elective replacemehe ECAT DVTnt hip surgery by preoperative clinical and haemostatic variables:the ECAT DVT Study:European Concerted Action on Thrombosis.Thromb Haemost 1999; 81:879-886
83. Glimore R,Doyle M,Holden F,et al. Activated protein C resistance factor V Leiden and assessment of thrombotic risk.Ir Med J 2008; 101:256-257
84. Prevention of venous thrombosis and pulmonary embolism:NIH Consensus Development. JAMA 1986; 256:744-799
85 Weinmann, E, Salzman, E. W:Deep-vein thrombosis. New England J. Med., 1994331:1630-1641
86 Warwick D, Williams MH, Bannister GC. Death and thromboembolic disease after total hip replacement A series of 1162 cases with no routine chemical prophylaxis. J Bone Joint Surg Br 1995; 77-B (1):6-10
87. Geerts WH, Bergqvist D, Pineo GF, et al. Prevention of venous thromboembolism: American college of chest physicians evidence-based clinical practice guidelines.8th edition. Chest 2008; 133(Suppl 6):381S-453
88 Trousseau A. Lectures on clinical medicine delivered at the Hotel-Dieu ParisLondon:New Sydenham Society; 1865. P228-332.
89. Bottner F,Sculco TP;Nonpharmacologic thromboembolic prophylaxis in total knee arthroplasty. Clin Orthop Relat Res 2001,392:249-256
90. Epidemiology, risk factors, Pathophysiology and Pathogenesis.Respiration 2003, 70:7-30
91. Ferrari E,Baudouy M, Cerboni P;Clinical epidemiology of venous thromboembolic disease.Results of a French multicenter registry.Eur Heart J 1997,18:685-89
92. Trigillo-Santos AJ, Jines Punte.Association between long travel and venous thromboembolic disease:A systemtic review and meta-analysis of control studies. Ann Hematol 2008,87:79-86
93. TomassonQ Monach PA, Thromboembolic disease in vasculitis.Curr Opin Rheumatol 2009,21:41-46
94. Westrich GH, Specht LM, Sharrock NE. Pneumatic compression Hemodynamics in total hip arthroplasty. Clin Orthop Relat Res.2000; 372:180-191.
95. Sharrock NE, Go G, Harpel PC, et al. The John Charnley Award. Thrombogenesis during total hip arthroplasty. Clin Orthop Relat Res.1995; 319:16-27.\
96. Planes MH, Hirsh A, Total hip replacement and deep vein thrombosis. J-Bone Joint Surg Br 1990; 72,9-13
97 Ay C,Junbauer Lv, High concentrations of solube P-selection are associated with risk of venous thromboembolism and the P-selection.The 715 variants,Clin Chem 2007,53:1235-1243
98. Imperiale TF, Speroff T. A meta-analysis of methods to prevent venous thromboembolism following total hip replacement. Jama.1996 Jun 8; 271(22):1780-5.
99. Beksac B, Gonzalez Delia Valle A, and Salvati EA. Thromboembolic disease after total hip arthroplasty:Who is at risk? Clin Orthop Relat Res.2006;453:211-24
100Butt AJ, McCarthy T, Kelly IP, et al. Sciatic nerve palsy secondary to postoperative haematoma in primary total hip replacement. J Bone Joint Surg Br. 2005 November 1,2005; 87-B (11):1465-7.
101. Callaghan JJ, Dorr LD, Engh GA, et al. Prophylaxis for thromboembolic disease. J Arthroplasty.2005 Apr; 20(3):273-4.
102. Freedman KB, Brookenthal KR, H. FR,Jr, et al. A meta-analysis of thromboembolic prophylaxis following elective total hip arthroplasty. J Bone Joint Surg Am.2000 Jul; 82-A (7):929-38.
103. Friedman RJ, Dunsworth GA. Cost analyses of extended prophylaxis with enoxaparin after hip arthroplasty. Clin Orthop.2000 Jan (370):171-82.
104. Imperiale TF, Speroff T. A meta-analysis of methods to prevent venous thromboembolism following total hip replacement. Jama.1994 Jun 8; 271(22):1780-5.
105. Salvati EA, Sharrock NE, Gonzalez Della Valle A. Current concepts in the pathogenesis, diagnosis and multimodal prophylaxis of thromboembolism disease following total hip replacement. Minerva Ortopedica e Traumatologica. 2003;54(5):381-401.
106. Shaieb MD, Watson BN, Atkinson RE. Bleeding complications with enoxaparin for deep venous thrombosis prophylaxis. J Arthroplasty.1999 Jun; 14(4):432-8.
107. Beksac BP, Gonzalez Della Valle A, Salvati EA. Acute sciatic nerve palsy as a delayed complication of low-molecular-weight heparin prophylaxis after total hip arthroplasty. Am J Orthop.2009 Feb; 38(2):E28-30.
108. W. CC, Jr, Berkowitz SD, Lieberman JR, et al. Oral direct thrombin inhibitor ximelagatran compared with warfarin for the prevention of venous thromboembolism after total knee arthroplasty. J Bone Joint Surg Am.2005 Oct; 87(10):2169-77.
109. Dearborn JT, Harris WH. Postoperative mortality after total hip arthroplasty. An analysis of deaths after two thousand seven hundred and thirty-six procedures. J Bone Joint Surg Am.1998 Sep; 80(9):1291-4.
110. D. PV, Jr, Donaldson CT, Farber DC, et al. The John charnley award:Prevention of readmission for venous thromboembolic disease after total hip arthroplasty. Clin Orthop Relat Res.2005 Dec; 441:56-62.
111. Planes A, Samama MM, Lensing AW, et al. Prevention of deep vein thrombosis after hip replacement--comparison between two low-molecular heparins, tinzaparin and enoxaparin. Thromb Haemost.1999 Jan; 81(1):22-5.
112 Lachiewicz PF, Kelley SS, Haden LR. Two mechanical devices for prophylaxis of thromboembolism after total knee arthroplasty. A prospective, randomised study. J Bone Joint Surg Br.2004 Nov; 86(8):1137-41.
113 Mantilla CB, Horlocker TT, Schroeder DR, et al. Risk factors for clinically relevant pulmonary embolism and deep venous thrombosis in patients undergoing primary hip or knee arthroplasty. Anesthesiology.2003 Sep; 99(3):552,60; discussion 5A.
114. Memtsoudis SG, Besculides MC, Gaber L, et al. Risk factors for pulmonary embolism after hip and knee arthroplasty:A population-based study. Int Orthop. 2008 Oct 17
115 Lieberman JR. Venous thromboembolism after total hip arthroplasty In: Callaghan JJ, Rosenberg AG, Rubash HE, editors. The Adult Hip. Philadelphia: Lippincott-Raven; 1998; p.633-46.
116. Mantilla CB, Horlocker TT, Schroeder DR, et al. Frequency of myocardial infarction, pulmonary embolism, deep venous thrombosis, and death following primary hip or knee arthroplasty. Anesthesiology.2002 May; 96(5):1140-6.
117. Salvati EA, Gonzalez Della Valle A, Westrich GH, et al. The John charnley award: Heritable thrombophilia and development of thromboembolic disease after total hip arthroplasty. Clin Orthop Relat Res.2005 Dec; 441:40-55.
118 Miles JS, Miletich JP, Goldhaber SZ, et al. G20210A mutation in the prothrombin gene and the risk of recurrent venous thromboembolism. J Am Coll Cardiol. 2001 Jan; 37(1):215-8.
119. Pabinger I, Grafenhofer H, Kaider A, et al. Preeclampsia and fetal loss in women with a history of venous thromboembolism. Arterioscler Thromb Vase Biol.2001 May; 21(5):874-9.
120. Westrich GH, Weksler BB, Glueck CJ, et al. Correlation of thrombophilia and hypofibrinolysis with pulmonary embolism following total hip arthroplasty:An analysis of genetic factors. J Bone Joint Surg Am.2002 Dec; 84-A (12):2161-7.
121. Gomes MPV, Deitcher SR. Risk of venous thromboembolic disease associated with hormonal contraceptives and hormone replacement therapy:A clinical review. Arch Intern Med.2004 October 11,2004; 164(18):1965-76.
122. Rosendaal FR, Helmerhorst FM, Vandenbroucke JP. Female hormones and thrombosis. Arterioscler Thromb Vase Biol.2002 February 1,2002; 22(2):201-10.
123Beksac B, Gonzalez Della Valle A, Anderson J, et al. Symptomatic thromboembolism after one-stage bilateral THA with a multimodal prophylaxis protocol. Clin Orthop Relat Res.2007 Oct; 463:114-9.
124 Anders MJ,Lifeso RM,Landis M,et al. Effect of preoperative donation of autologous blood on deep-vein thrombosis following total joint arthroplasty of the hip or knee.J Bone Joint Surg Am 1996;78-A:574-80
125.Pearson TC. Heamorheologic considerations in the pathogenesis of vascular occlusive events in polycythemia vera.Semi thromb Hemost 1997; 23:433-9
126. Manouri Taleghani B,Manke F,Langer R,et al.Changes in blood rheology and microcirculation after preparatory combined thrombocytopheresis and plasmaphresis.Beitr infusionsher Transfusionsmed 1997;34:123-7
127.Blachman MA, Bordin JO, Bardossy L, et al. The contribution of the haematocrit to thrombocytopenic bleeding in experimental animals. Br J Haematol 1994; 86:2347-50
128. Dietrich QKretschmer V,Orth D,et al. Primary hemostasis in hemodilution-1 Hemocrit. Infusionstherapie 1990; 17:212-3
129. Dietrich G, Orth D, Haupt Wrimary hemostasisi in hemod, et al. Primary hemostasis in hemodilution-2 infusion solutions. Infusiontherapie 1990; 17:214-6
130.Valeri DR,Macgregor H,Cassidy Q et al.Effects of temperature on bleeding time and clotting time in normal male and female volunteers. Crit Care Med 1995; 23:698-704
131. Cabibbo S, Garozzo G, Antolino A, et al. Continuous improvement of our autologous blood donation program carried out during 10 years in 1198 orthopaedic patients Transfus Apher Sci.2009 Feb; 40(1):13-7
132. Kubota R, Nozawa M, Matsuda K,et al. Combined preoperative autologous blood donation and intra-operative cell salvage for hip surgery J Orthop Surg (Hong Kong).2009 Dec; 17(3):288-90.
133. Modig J. Influence of regional nesthesia.local anesthetics and sympathicominmetics on the pathophysiology of deep vein thrombosis.Acta Chir Scand Suppl 1989; 550:119-27
134. Sharrock NE,Go G,Mineo R;The hemodynamic and fibrinolytic response to low dose epinephrine and phenlephrine infusions during total hip replacement under epidural anesthesia. Thromb Haemost 1992;68:436-41
135. Sculco TP, Ranawat C. The use of spinal anesthesia for total hip-replacement arthroplasty. J Bone Joint Surg Am.1975 Mar; 57(2):173-7.
136.Brooks PJ, Keramati M, Wickline A. Thromboembolism in patients undergoing total knee arthroplasty with epidural analgesia. J Arthroplasty.2007 Aug; 22(5):641-3.
137. Bading B, Blank SG, Sculco TP, et al. Augmentation of calf blood flow by epinephrine infusion during lumbar epidural anesthesia. Anesth Analg.1994 Jun; 78(6):1119-24.
138 Mineo R, Sharrock NE. Pulse oximeter waveforms from the finger and toe during lumbar epidural anesthesia. Reg Anesth.1993 Mar-Apr; 18(2):106-9
139 Williams-Russo P, Sharrock NE, Mattis S, et al. Cognitive effects after epidural vs general anesthesia in older adults. A randomized trial. Jama.1995 Jul 5; 274(1):44-50
140. Gitel SN, Salvati EA, Wessler S, et al. The effect of total hip replacement and general surgery on antithrombin Ⅲ in relation to venous thrombosis. J Bone Joint Surg Am.1979 Jul; 61(5):653-6.
141. Huo MH, Salvati EA, Sharrock NE, et al. Intraoperative adjusted-dose heparin thromboembolic prophylaxis in primary total hip arthroplasty. Clin Orthop.1992 Apr; 277:188-96.
142. Huo MH, Salvati EA, Sharrock NE, et al. Intraoperative heparin thromboembolic prophylaxis in primary total hip arthroplasty. A prospective, randomized, controlled, clinical trial. Clin Orthop Relat Res.1992 Jan;(274) (274):35-46.
143. Sharrock NE, Brien WW, Salvati EA, et al. The effect of intravenous fixed-dose heparin during total hip arthroplasty on the incidence of deep-vein thrombosis. A randomized, double-blind trial in patients operated on with epidural anesthesia and controlled hypotension. J Bone Joint Surg Am.1990 Dec; 72(10):1456-61.
144. Dahl OE. The role of the pulmonary circulation in the regulation of coagulation and fibrinolysis in relation to major surgery. J Cardiothorac Vase Anesth.1997 May; 11(3):322-8.
145. Sharrock NE, Go G, Sculco TP, et al. Dose response of intravenous heparin on markers of thrombosis during primary total hip replacement. Anesthesiology. 1999 Apr; 90(4):981-7.
146. Westrich GH, Salvati EA, Sharrock N, et al. The effect of intraoperative heparin administered during total hip arthroplasty on the incidence of proximal deep vein thrombosis assessed by magnetic resonance venography. J Arthroplasty.2005 Jan; 20(1):42-50.
147.Binns M, Pho R. Femoral vein occlusion during hip arthroplasty. Clin Orthop. 1990 Jun; 255:168-72.
148. Stamatakis JD, Kakkar VV, Sagar S, et al. Femoral vein thrombosis and total hip replacement. Br Med J.1977 Jul 23; 2(6081):223-5.
149. Christie J, Robinson CM, Singer B, et al. Medullary lavage reduces embolic phenomena and cardiopulmonary changes during cemented hemiarthroplasty. J Bone Joint Surg Br.1995 May; 77(3):456-9.
150. Pitto RP, Hamer H, Fabiani R, et al. Prophylaxis against fat and bone-marrow embolism during total hip arthroplasty reduces the incidence of postoperative deep-vein thrombosis:A controlled, randomized clinical trial. J Bone Joint Surg Am.2002 Jan;84-A(1):39-48.
151. Bishop NE, Ferguson S, Tepic S. Porosity reduction in bone cement at the cement-stem interface. J Bone Joint Surg Br.1996 May; 78(3):349-56.
152. Dall DM, Miles AW, Juby G. Accelerated polymerization of acrylic bone cement using preheated implants. Clin Orthop.1986 Oct; 211:148-50.
153.Iesaka K, Jaffe WL, Kummer FJ. Effects of preheating of hip prostheses on the stem-cement interface. J Bone Joint Surg Am.2003 Mar; 85-A (3):421-7.
154. Parks ML, Walsh HA, Salvati EA, et al. Effect of increasing temperature on the properties of four bone cements. Clin Orthop.1998 Oct; 355:238-48.
155. Viscusi ER, Martin G, Hartrick CT, et al. Forty-eight hours of postoperative pain relief after total hip arthroplasty with a novel, extended-release epidural morphine formulation. Anesthesiology.2005 May; 102(5):1014-22.
156.Pagnani MJ, Pellicci PM, Salvati EA. Effect of aspirin on heterotopic ossification after total hip arthroplasty in men who have osteoarthrosis. J Bone Joint Surg Am.1991 Jul; 73(6):924-9.
157. Bek D, Beksac B, Gonzalez Della Valle A, et al. Aspirin decreases the prevalence and severity of heterotopic ossification after 1-stage bilateral total hip arthroplasty for osteoarthrosis. J Arthroplasty.2009 Feb; 24(2):226-32.
158. Shepard M, Mills C. Fatal pulmonary embolism following hip and knee replacement. A study of 2153 cases using routine mechanical prophylaxis and selective chemoprophylaxis. Hip Int.2006; 16(1):53-6.
159. Blom A, Pattison G, Whitehouse S, et al. Early death following primary total hip arthroplasty:1,727 procedures with mechanical thrombo-prophylaxis. Acta Orthop.2006 Jun;77(3):347-50.
160. D'Andrea G, D'Ambrosio RL, Di Perna P, et al. A polymorphism in the:VKORC1 gene is associated with an interindividual variability in the dose-anticoagulant effect of warfarin. Blood.2005 Jan 15; 105(2):645-9.
161. Kohnke H, Sorlin K, Granath G, et al. Warfarin dose related to apolipoprotein E (APOE) genotype. Eur J Clin Pharmacol.2005 Jul; 61(5-6):381-8.
162. Kosaki K, Yamaghishi C, Sato R, et al.1173C>T polymorphism in VKORC1 modulates the required warfarin dose. Pediatr Cardiol.2006 Nov-Dec; 27(6):685-8.
163. Salvati EA, Lachiewicz P. Thromboembolism following total hip-replacement arthroplasty. The efficacy of dextran-aspirin and dextran-warfarin in prophylaxis. J Bone Joint Surg Am.1976 Oct; 58(7):921-5.
164. Gonzalez Della Valle A, Salonia Ruzo P, Salvati EA. Warfarin-associated intracapsular hemorrhage causing an acutely painful total hip arthroplasty:A rare complication of prolonged anticoagulant therapy. J Arthroplasty.2000 Aug; 15(5):668-70.
165.Rosove MH, Grody WW. Should we be applying warfarin pharmacogenetics to clinical practice? no, not now. Ann Intern Med.2009 Aug 18; 151(4):270,3, W95.
166.Harm CL, Streiff MB. The role of vena caval filters in the management of venous thromboembolism. Blood Rev.2005 Jul; 19(4):179-202.
167. Francis CW, Berkowitz SD, Comp PC, et al. Comparison of ximelagatran with warfarin for the prevention of venous thromboembolism after total knee replacement. N Engl J Med.2003 Nov 30; 349(18):1703-12.
168. W. CC,Jr, Collis DK, Paulson R, et al. Comparison of enoxaparin and warfarin for the prevention of venous thromboembolic disease after total hip arthroplasty. evaluation during hospitalization and three months after discharge. J Bone Joint Surg Am.1999 Jul; 81(7):932-40.
169. Hull R, Raskob G, Pineo G, et al. A comparison of subcutaneous low-molecular-weight heparin with warfarin sodium for prophylaxis against deep-vein thrombosis after hip or knee implantation. N Engl J Med.1993 Nov 4; 329(19):1370-6.
170. Hull RD, Pineo GF, Francis C, et al. Low-molecular-weight heparin prophylaxis using dalteparin in close proximity to surgery vs warfarin in hip arthroplasty patients:A double-blind, randomized comparison. The North American fragmin trial investigators. Arch Intern Med.2000 Jul 24; 160(14):2199-207.
171. Warkentin TE, Greinacher A. Heparin-induced thrombocytopenia:Recognition, treatment, and prevention:The seventh ACCP conference on antithrombotic and thrombolytic therapy. Chest.2004 Sep; 126(3 Suppl):311S-37S.
172. Lieberman JR, Huo MM, Hanway J, et al. The prevalence of deep venous thrombosis after total hip arthroplasty with hypotensive epidural anesthesia. J Bone Joint Surg Am.1994 Mar; 76(3):341-8.
173.Leclerc JR, Gent M, Hirsh J, et al. The incidence of symptomatic venous thromboembolism after enoxaparin prophylaxis in lower extremity arthroplasty: A cohort study of 1,984 patients. Canadian collaborative group. Chest.1998 Aug; 114(2 Suppl Evidence):115S-8S.
174. Lotke PA, Palevsky H, Keenan AM, et al. Aspirin and warfarin for thromboembolic disease after total joint arthroplasty. Clin Orthop.1996 Mar; 324:251-8.
175. Warwick D, Harrison J, Glew D, et al. Comparison of the use of a foot pump with the use of low-molecular-weight heparin for the prevention of deep-vein thrombosis after total hip replacement. A prospective, randomized trial. J Bone Joint Surg Am.1998 Aug; 80(8):1158-66.
176. Parry M, Wylde V, Blom AW. Ninety-day mortality after elective total hip replacement:1549 patients using aspirin as a thromboprophylactic agent. J Bone Joint Surg Br.2008 Mar; 90(3):306-7.
177. Bozic KJ, Vail TP, Pekow PS, et al. Does aspirin have a role in venous thromboembolism prophylaxis in total knee arthroplasty patients? J Arthroplasty. 2009 Aug 11
178. Callaghan JJ, Dorr LD, and Engh GA, et al. Prophylaxis for thromboembolic disease:recommendations from the American College of Chest Physicians-are they appropriate for orthopaedic surgery? J Arthroplasty 2005; 20:273
179. American Academy of Orthopaedic Surgeons clinical guideline on prevention of symptomatic pulmonary embolism in patients undergoing total hip or knee arthroplasty. Available at http://www.aaos.org/Research/guidelines/guide.asp, 2007.
180. Eikelboom JW, Quinlan DJ, Douketis JD. Extended-duration prophylaxis against venous thromboembolism after total hip or knee replacement:a meta-analysis of the randomised trials. Lancet 2001; 358(9275):9-15.
181. Virchow R. Neuer fall von todlicher emboli der lungenarterie. Arch Pathol Anat. 1856; 10:225-8.2008。 3(28):54-55.
182 Falck-Ytter Y, Francis CW, Johanson NA, et al; American College of Chest Physicians:Prevention of VTE in orthopedic surgery patients:Antithrombotic Therapy and Prevention of Thrombosis,9th ed. American College of Chest Physicians Evidence-BasedClinical Practice Guidelines. Chest 2012; 141(2 suppl):e278S-e325S
183 Mont MA, Jacobs JJ:AAOS clinical practice guideline:Preventing venous thromboembolic disease in patients undergoing elective hip and knee arthroplasty. J Am Acad Orthop Surg 2011;19(12):777-778.
184. Lieberman J R:The new AAOS clinical practice guidelines on venous thromboembolic prophylaxis:How to adapt them to your practice. J Am Acad Orthop Surg 2011;19(12):717-721.
185. Walsh JJ,Bonnar J,Wright FW. A study of pulmonary embolism and deep leg vein thrombosis after major gynecologic surgery using labeled fribinogen-phlegbograpgy and lung scanning.J Obstet Gynecol Br Commonw,1974,81:311-316
186.Clarke-Pearson DL,Jelovesk FR,Creasman WT.Thromboembolism complicating surgery for cervical and uterine malignancy:incidence,risk factors, and prophylaxis.Obstet Gynecol,1983,61:87-94.
187.Goldhaber SE.Epidemiology of pulmonary embolism and deep vein-thrombosis. In:Bloom Al, Forbes CD, Thomas DP, eds.Haemostasis and thrombosis. London:Churchill,1994,1327
188.Thomas DP. Pathogenesis of venous thrombosis. In:Bloom Al, Fobes CD,Thomas DP, eds.Haemostasis and thrombosis. London:Churchill,1994,1335
1898. Allaart CF,Briei E.Familial venous thrombophilia. In:Bloom AL,Forbes CD,Thomas DP, eds. Haemostasis and thrombosis. London:Churchill, 1994,1349
190. Begamini TM,Richardson JD.The surgical implications of prinary hypercoagulation status.J Ky Med Assoc,1997,2:67-72
191. Bhatia M, Moochhala S. Role of inflammatory mediators in the pathophysiology of acute respiratory distress syndrome. J Pathol.2004;202(2):145-156
192. der C, Eichelbr?nner O, Roewer N. Are IL-6, IL-10 and PCT plasma concentrations reliable for outcome prediction in severe sepsis? A comparison with APACHE III and SAPS II. Inflamm Res.2004;53(4):158-163.
193.C erm ak J, K ey N S, B ach RR, et a 1. C-react ive pro tein induces hum an peripheral b lood m onocy tes to synthesiz e tissu e factor. Blood,1993; 82(2):513-520
194.马骊；任凤霞；张林.全髋关节置换后血清炎性因子表达及深静脉血栓形成57例分析.中国组织工程研究与临床康复.2009,1；22：
195. Fox EA, K ahn SR. T he relat ionship betw een inf lamm ation and ven ou s throm bos is. A system at ic rev iew of clin ical stud ies. T hrom b H aem os,t 2005; 94(2):362-365
196.杨林,祁光裕,李艳姿.C-反应蛋白与急性下肢深静脉血栓症反应的研究.中国现代普通外科进展,2006,10(5)：398-400
197. Folsom AR, L utsey PL, A stor BC, et a 1. C-react ive p ro tein and venous th rom boem bo lism. A prospective inv est igation in the ARICcohor.t Throm b H aem o s,t 2009; 102(4):615-619
198. No rdenho lz KE, M itch ellAM, K line JA. D irect com parison of the diagnost ic accuracy o f fifty protein b io log icalm arkers of pulmonary emboism for use in the em ergency department A cad Em erg M ed,2008; 15(9):795-799
199.Roumen-K1 appe EM, den H eijer M, van Uum SH, et al. Inflammat ory response in th e acut e phase of deep vein thrombosis [J]. J Vase S urg,2002; 35(4):701-706.
200.Thomas EA,Cobby MJ,Phys DE, et al. Liquid crystal thermography and C-recative protein in the detection of deep venous thrombosis.BMJ 1989;299:951-2
200. Bucek RA, Reit er M, Quehenberger P, et al. C-react ive p rotein in th e diagnosis of deep vein thr om bosis [J]. Br JH aemat ol,2002; 119(2):385-389.
201. Krieg er E, van Der L oo B, Amann-Vest i BR, et al. C-reactive prot ein and r ed cell aggregat ion cor relat e w ith 1 at e venousfunct ion aft er acu te deep venous thrombosi s [J]. J VascSu rg,2004; 40(4):644-649.
1. Geerts WH, Pineo GF, Heit JA, et al:Prevention of venous thromboembolism:The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 2004; 126(3 suppl): 338S-400S
2 Greets WH, Heit JA, Clagett GP, et al Prevention of venous thromboembolism.Chest.2001; 19(1 Suppl):132S-175S.
3 American Academy of Orthopaedic Surgeons clinical guideline on prevention of symptomatic pulmonary embolism in patients undergoing total hip or knee arthroplasty. Available at http://www.aaos.org/Research/guidelines/guide.asp,2007.
4 Greets WH,Bergqvist D,Pineo GF, et al.Prevention of venous thromboembolism:American College of Chest Physicians evidence-based clinical pratice guidelines(8th edition). Chest 2008,133,381S-453S
5 Trousseau A. Lectures on clinical medicine delivered at the Hotel-Dieu ParisLondon:New Sydenham Society; 1865. p228-332.
6Stamatakis JD, Kakkar VV, Sager S, Lawrence D, Naim D, Bentley PG:Femoral vein thrombosis and total hip replacement. BMJ 1977;2:223-225.
7 Binns M, Pho R:Femoral vein occlusion during hip arthroplasty. Clin Orthop Relat Res 1990;255:168-172.
8 Bottner F.Sculco TP:Nonpharmacologic thromboembolic prophylaxis in total knee arthroplasty.Clin Orthop Relat Res,2001,392:249-256
9 Arcangelo, V. P., & Peterson, A. M. (2006). Pharmacotherapeutics for advanced practice:A practical approach (2nd ed.). Philadelphia:Lippincott Williams & Wilkins.
10 Morris CD,Creevy WS,Einbom TA,et al. Pulmonary dietress and thromboembolic comditions affecting orthopaedic pratice,Chapter 12 Buckwalter JA,Einborn TA.Simon SR(eds):Orthpaedic Basic Science:Biology and the Biomechanics of the Musculoskeletal Symtem,2nd. Rosemont,IL,American Academy of Orthopaedi Surgeons,2000
11Planes A, Vochelle N, Fagola M. Total hip replacement and deep vein thrombosis. A venographic and necropsy study. J Bone Joint Surg Br.1990;72:9-13.
12. Arcelus JI, Caprini JA, Traverso CI. Venous thromboembolism after hospital discharge. Semin Thromb Hemost.1993; 19 Suppl 1:142-6.
13 Johnson R, Green JR, Charnley J. Pulmonary embolism and its prophylaxis following the Charnley total hip replacement. Clin Orthop Relat Res.1977;127:123-132.
14 Prevention of venous thrombosis and pulmonary embolism:NIH Consensus Development. JAMA 1986; 256:744-799
15Lieberman JR, Geerts WH. Prevention of venous thromboembolism after total hip and knee arthroplasty. J Bone Joint Surg Am.1994;76:1239-50.
16 Clagett GP, Anderson FA Jr, Levine MN, Salzman EW, Wheeler HB. Prevention of venous thromboembolism. Chest.1992;102(4 Suppl):391S-407S
17 Murray, DW,Britton, AR,Bulstrode, CJ:Thromboprophylaxis and death after total hip replacement. J. Bone and Joint Surg.,1996; 78-B (6):863-870,
18. Fender D, Harper WM, Thompson JR, Gregg PJ. Mortality and fatal pulmonary embolism after primary total hip replacement:results from a regional hip register. J Bone Joint Surg [Br] 1997; 79-B:896-9
19. Gonzalez Della Valle A, Serota A, Go G, et al. Venous thromboembolism is rare with a multimodal prophylaxis protocol after total hip arthropasty. Clin Orthop 2006; 444:146-53.
20. Cusick LA, Beverland DE. The incidence of fatal pulmonary embolism after primary hip and knee replacement in a consecutive series of 4253 patients. J Bone Joint Surg Br.2009 May; 91(5):645-8
21 Rodgers A, Walker N, Schug S, et al. Reduction of postoperative mortality and morbidity with epidural or spinal anesthesia:results from overview of randomized trials. BMJ 2000; 321:1493.
22 Davis F.M; Laurenson V.G; Gillespie W.J, et al. Deep vein thrombosis after total hip replacement. A comparison between spinal and general anesthesia. J Bone and Joint Surg, 1989,71-B (2):181-185
23 Modig J, Borg T, Karisrom G, et al. Thromboembolism after total hip replacement:role of epidural and general aensthesia. Anesth and Anal,1983,62:174-180
24 Rodgers A, Walker N, Schug S, et al:Reduction of postoperative mortality and morbidity with epidural or spinal anesthesia:Results from overview of randomized trials. BMJ 2000; 32125 Bading B, Blank S, Sculco TP, Pickering TG, Sharrock NE:Augmentation of calf blood flow by epinephrine infusion during lumbar epidural anesthesia. Anesth Analg 1994; 78:1119-1124.
26 Eroglu A, Uzunlar H, Erciyes N. Comparison of hypotensive epidural anesthesia and hypotensive total intravenous anesthesia on intraoperative blood loss during total hip replacement. Journal of Clinical Anesthesia 200517,420-425
27 Sharrock NE, Mineo R, Urquhart B, Salvati EA. The effect of two levels of hypotension on intraoperative blood loss during total hip arthroplasty performed under lumbar epidural anesthesia. Anesth Analg.1993; 76:580-584.
28 Lieberman JR, Huo MM, Hanway J, Salvati EA, Sculco TP, Sharrock NE. The prevalence of deep venous thrombosis after total hip arthroplasty with hypotensive epidural anesthesia. J Bone Joint Surg Am.1994; 76:341-348
29 Westrich GH, Farrell C, Bono JV, Ranawat CS, Salvati EA, Sculco TP. The incidence of venous thromboembolism after total hip arthroplasty:a specific hypotensive epidural anesthesia protocol. J Arthroplasty.1999; 14:456-463.
30 Sharrock NE,Bading B,Mineo R,et al. Deliberate hypotensive epidural anesthesia for patients with normal and low cardiac output. Anesth Analg 1994; 79:899-904
31 Williams-Russo P, Sharrock NE, Mattis S, Szatrowski TP, Charlson ME. Cognitive effects after epidural vs general anesthesia in older adults:a randomized trial. JAMA.1995; 274:44-50
32 Gardner AM, Fox RH:The venous foot pump:Influence on tissue perfusion and prevention of venous thrombosis. Ann Rheum Dis 1992; 51:1173-1178
33 Dai G, Gertler JP, Kamm RD:The effects of external compression on venous blood flow and tissue deformation in the lower leg. J Biomech Eng 1999; 121:557-564.
34 Westrich GH, Specht LM, Sharrock NE, Sculco TP, Salvati EA,Pellicci PM, Trombley JF, Peterson M. Pneumatic compression hemodynamics in total hip arthroplasty. Clin Orthop Relat Res.2000; 372:180-191.
35 Ryan MG, Westrich GH, Potter HG, Sharrock N, Maun LM, Macaulay W, Katkin P, Sculco TP, Salvati EA. Effect of mechanical compression on the prevalence of proximal deep venous thrombosis as assessed by magnetic resonance venography. J Bone Joint Surg Am.2002; 84:1998-2004.
36 Lachiewicz PF, Soileau ES. Multimodal prophylaxis for THA with mechanical compression. Clin Orthop Relat Res.2006; 453:225-230
37. Froimson M, Murray TG, Fazekas AF. Venous Thromboembolic Disease Reduction with a Portable Pneumatic Compression Device. J Arthroplasty 2009,24:310-316
38 Bek D, Beksac B, Gonzalez Della Valle A, et al:Aspirin decrease the prevalence and severity of heterotopic ossification after 1-stage bilateral total hip arthroplasty for osteoarthrosisJ Arhtroplasy 2009,24:226-232
39 Pulmonary Embolism Prevention (PEP) Trial Collaborative Group. Prevention of pulmonary embolism and deep vein thrombosis with low dose aspirin:pulmonary embolism prevention (PEP) trial. Lancet 2000; 355(9212):1295-302.
40 Collaborative overview of randomized trials of antiplatelet therapy:Ⅲ. Reductionin venous thrombosis and pulmonary embolism by ant platelet prophylaxis among surgical and medical patients:Antiplatelet Trialists'Collaboration.BMJ 1994; 308:235-246.
41 Lotke PA, Lonner JH:The benefit of aspirin chemoprophylaxis for thromboembolism after total knee arthroplasty. Clin Orthop Relat Res 2006; 452:175-180.
42 Bozic K J. Vail T P, Pekow P S, et al. Does Aspirin Have a Role in Venous Thromboembolism Prophylaxis in Total Knee Arthroplasty Patients? J Arthroplasty 2009 Vol.00 No.01-8
43 Eikelboom JW, Quinlan DJ, Douketis JD. Extended-duration prophylaxis against venous thromboembolism after total hip or knee replacement:a meta-analysis of the randomised trials. Lancet 2001; 358(9275):9-15.
44 Colwell CW Jr, Collis DK, Paulson R, et al. Comparison of enoxaparin and warfarin for the prevention of venous thromboembolic disease after total hip arthroplasty. Evaluation during hospitalization and three months after discharge. J Bone Joint Surg Am 1999; 81(7):932-40.
45 Sharrock NE, Gonzalez Della Valle A, Go G, Lyman S, Salvati EA. Potent anticoagulants are associated with a higher all-cause mortality rate after hip and knee arthroplasty. Clin Orthop Relat Res 2008; 466:714-21
46 Neviaser A S., Chang C, Lyman S,et al High Incidence of Complications From Enoxaparin Treatment After Arthroplasty. Clin Orthop Relat Res 2010; 468:115-119
47 Lieberman J R, John W, Frederick D, et al. The Efficacy of Prophylaxis with Low-Dose Warfarin for Prevention of Pulmonary Embolism following Total Hip Arthroplasty. J Bone Joint Surg [Am] 1997; 79-A; 319-25
48 Pellegrini VD Jr. Warfarin prophylaxes for orthopaedic venous thromboembolicdisease. Instr Course Lect.2002; 51:491-8.
49. Pellegrini VD Jr, Donaldson CT, Farber DC, Lehman EB, Evarts CM. Prevention of readmission for venous thromboembolic disease after total hip arthroplasty. Clin Orthop Relat Res.2005; 441:56-62.
50. Pellegrini VD Jr, Donaldson CT, Farber DC, Lehman EB, Evarts CM. Prevention of readmission for venous thromboembolism after total knee arthroplasty. Clin Orthop Relat Res. 2006; 452:21-7.
51 Lieberman J R, Barnes CL, Lachiewicz P F., Hanssen A D., Clarke H D, Pellegrinit VD Jr. Venous Thromboembolism Debate in Joint Arthroplasty. J Bone Joint Surg Am.2009; 91:29-32.
52 Pendleton RC, PharmD WM, Wanner N, et al. A Safe, Effective, and Easy to Use Warfarin Initiation Dosing Nomogram for Post-Joint Arthroplasty Patients. J Arthroplasty 2010,25, 1,121-127
53 Harenberg J, Wehling M. Current and future prospects for anticoagulant therapy:inhibitors of factor Xa and factor IIa. Semin Thromb Hemost 2008; 34:39-57.
54 Lassen MR, Davidson BL, Gallus A, et al. The efficacyand safety of apixaban, an oral, direct factorXa inhibitor, as thromboprophylaxis in patientsfollowing total knee replacement. J Thromb Haemost 2007; 5(12):2368-75.
55 Lassen MR, Raskob GE, Gallus A, et al. T Apixaban or Enoxaparin forThromboprophylaxis after Knee Replacement. N Engl J Med 2009; 361:594-604.
56 Kakkar AK, Brenner B, Dahl OE, et al. Extended duration rivaroxaban versus short-term enoxaparin forthe prevention of venous thromboembolism after totalhip arthroplasty:a double-blind, randomised controlled trial. Lancet 2008; 372:31-39.
57 Lazo-Langner A, Rodger MA, Wells PS. Lessonsfrom ximelagatran. Issues for future studies evaluating new oral direct thrombin inhibitors for venous thromboembolism prophylaxis in orthopedic surgery. Clin Appl Thromb Hemost, in press.
58. Eriksson BI, Dahl OE, Buller HR, et al. A new oral direct thrombin inhibitor, dabigatran etexilate, compared with enoxaparin for prevention of thromboembolic events following total hip or knee replacement:the BISTRO II randomized trial. J Thromb Haemost 2005; 3(1):103-11.
59. Eriksson BI, Dahl OE, Ahnfelt L, et al. Dose escalating safety study of a new oral direct thrombin inhibitor, dabigatran etexilate, in patients undergoing total hip replacement:BISTRO I. J Thromb Haemost 2004;2(9):1573-80.
60 Bae H, Westrich GH, Sculco TP, Salvati EA, Reich LM. The effect of preoperative donation of autologous blood on deep-vein thrombosis after total hip arthroplasty. J Bone Joint Surg Br. 2001; 83:676-679.
61 Sharrock N, Go G, Mayman D, Sculco TP. Decreases in pulmonary artery oxygen saturation during total hip arthroplasty:variations using two leg positioning techniques. J Arthroplasty. 2005; 20:499-502.
62 Salvati EA, Gonzalez Della Valle A. Thromboembolism following total hip replacement. J Long Term Eff Med Implants.2003; 13:325-340.
63. Salvati EA, Gonzalez Della Valle A, Westrich GH, Rana AJ, Specht L, Weksler BB, Wang P, Glueck CJ. The John Charnley Award:heritable Thrombophilia and Development of Thromboembolic Disease after total hip arthroplasty. Clin Orthop Relat Res.2005; 441:40-55.
64. Salvati EA, Lachiewicz P. Thromboembolism following total hip replacement arthroplasty:the efficacy of dextran-aspirin and dextran-warfarin in prophylaxis. J Bone Joint Surg Am.1976; 58:921-925.
65. Salvati EA, Pellegrini VD Jr, Sharrock NE, Lotke PA, Murray DW, Potter H, Westrich GH. Recent advances in venous thromboembolic prophylaxis during and after total hip replacement. J Bone Joint Surg Am.2000; 82:252-270.
66 Sharrock NE, Go G, Harpel PC, Ranawat CS, Sculco TP, Salvati EA. The John Charnley Award:thrombogenesis during total hip arthroplasty. Clin Orthop Relat Res.1995; 319:16-2
67 Eduardo A.Salvati, Nigel F.Sharrock, Geoffrey Westrich, et al. The 2007 ABJS Nicolas Andry Award:three decades of linical, basic, and applied research on thromboembolic disease after THA. Clin Orthop Relat Res 2007; 459:246-254
68 Gonzalez Della Valle A, Reynoso FJ, Ari JB, Salvati E. The multimodal approach for the prevention of thromboembolic disease after total joint arthroplasty. Seminars in Arthroplasty 2009,20,4:241-250
1. Geerts WH, Pineo GF, Heit JA, et al:Prevention of venous thromboembolism:The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 2004; 126(3 suppl):338S-400S
2. Greets WH, Heit JA, Clagett GP, et al Prevention of venous thromboembolism.Chest.2001; 19(1 Suppl):132S-175S.
3。 revention of venous thrombosis and pulmonary embolism:NIH Consensus Development. JAMA 1986; 256:744-799
4。 einmann, E, Salzman, E. W:Deep-vein thrombosis. New England J. Med.,1994 331:1630-1641
5。 arwick D, Williams MH, Bannister GC. Death and thromboembolic disease after total hip replacement a series of 1162 cases with no routine chemical prophylaxis. J Bone Joint Surg Br 1995; 77-B (1):6-10
6. Geerts WH, Bergqvist D, Pineo GF, et al. Prevention of venous thromboembolism: American college of chest physicians evidence-based clinical practice guidelines. 8th edition. Chest 2008; 133(Suppl 6):381S-453
7. Murray, D. W.; Britton, A. R.; and Bulstrode, C. J. K.:Thromboprophylaxis and death after total hip replacement. J. Bone and Joint Surg.,1996; 78-B (6):863-870,
8. Fenders D, Harper WM, Thompson JR, Gregg PJ. Mortality and fatal pulmonary embolism after primary total hip replacement:results from a regional hip register. J Bone Joint Surg [Br] 1997; 79-B:896-9
9. Gonzalez Della Valle A, Serota A, Go G, et al. Venous thromboembolism is rare with a multimodal prophylaxis protocol after total hip arthropasty. Clin Orthop 2006; 444:146-53.
10. Cusick LA, Beverland DE. The incidence of fatal pulmonary embolism after primary hip and knee replacement in a consecutive series of 4253 patients. J Bone Joint Surg Br.2009 May; 91(5):645-8
11. Rodgers A, Walker N, Schug S, et al. Reduction of postoperative mortality and morbidity with epidural or spinal anesthesia:results from overview of randomized trials. BMJ 2000; 321:1493.
12. Lawrence D.Dorr, Vlad Genlelman, Aditya V.Maheshwari, et al. Multomodal thromboprophylaxis for total hip and knee arthroplasy baced on risk assessment J Bone Joint Surg Am.2007; 89:2648-57
13. Shaieb MD, Watson BN, Atkinson RE. Bleeding complication with enoxaparin for deep venous thrombosis prophylaxis. J Arthroplasty 1999; 14:432-438
14. Beksac BP, Gonzalez Della Valle A, Salvati EA. Acute sciatic nerve palsy as a delayed complication of low-molecular-weight heparin prophylaxis after total hip arthroplasty.Am J Orthop 2009,38:E20-E30.
15. Pellegrini VD Jr, Donaldson CT, Farber DC, ET AL.The John Charnley Award: Prevention of readmission for venous thromboembolic disease after total hip arthroplasty.Clin Orthop Relat Res 2005,441:56-62.
16. Heit JA,O'fallon WM, Petterson TM,et al. Relative impact of risk factors for deep vein thrombosis and pulmonary embolism:a population-based study. Arch Intern Med.2002; 162:1245-1248
17. Thodiyil PA, Kakkar AK.Variation in relative risk of venous thromboembolism in different cancers. Thromb Haemost.2002; 87:1076-1077
18. Murin S, Romano PS, White RH.Comparison of outcomes after hospitalization for deep venous thrombosis or pulmonary embolism. Thromb Haemost.2002; 88:407-414
19. Fisher B,Costantino JP,Wickerhan DL,et al.Tamoxifen for prevention of breast cancenreport of the National Surgical Adjuvant Breast and Bowel Project P-1 Study.J Natl Cancer Inst.1998;90:1371-1388
20. Cummings SR, Eckert S, Krueger KA, et al. The effect of raloxifene on risk of breast cancer in postmenopausal women:results from the MORE randomized trial. JAMA.1999; 281:2189-2197
21. Gomes MP, Deitcher SR. Risk of venous thromboembolic disease associated with hormonal contraceptives and hormone reolacement therapy:a clinical review.Arch Intern Med.2004; 164:1965-1976
22. Rosendaal FR, Helmerhorst FM, Vandenbroucke JP. Female hormones and thrombosis. Arterioscler Thromb Vasc Biol.2002; 22:201-210
23. Grady D,Wenger NK,Herrington D,et al. Postmenopausal hormone therapy increases risk for venous thrombo-embolic disease:the Heart and Estrogen/progestin Replacement Study. Ann Intern Med.2000; 132:689-696
24. Mantilla CB,Horlocker TT,Schroeder DR,et al. Risk factors for clinically relavent pulmonary embolism and deep venous thrombosis in patients undergoing primary hip or knee arthroplasty. Anesthesiology 2003; 99:552-560
25. Lowe GD,Haverkate F,Thompson SG,et al. Prediction of deep vein thrombosis after elective replacemehe ECAT DVTnt hip surgery by preoperative clinical and haemostatic variables:the ECAT DVT Study:European Concerted Action on Thrombosis.Thromb Haemost.1999; 81:879-886
26. Davis F.M; Laurenson V.G; Gillespie W.J, et al. Deep vein thrombosis after total hip replacement. A comparison between spinal and general anesthesia. J Bone and Joint Surg,1989,71-B (2):181-185
27. Modig J, Borg T, Karisrom G, et al. Thromboembolism after total hip replacement:role of epidural and general aensthesia. Anesth and Anal,1983, 62:174-180
28. Bading B, Blank S, Sculco TP, Pickering TG, Sharrock NE:Augmentation of calf blood flow by epinephrine infusion during lumbar epidural anesthesia.Anesth Analg 1994; 78:1119-1124.
29. Sharrock NE, Mineo R, Urquhart B, Salvati EA. The effect of two levels of hypotension on intraoperative blood loss during total hip arthroplasty performed under lumbar epidural anesthesia. Anesth Analg.1993; 76:580-584.
30. Lieberman JR, Huo MM, Hanway J, Salvati EA, Sculco TP, Sharrock NE. The prevalence of deep venous thrombosis after total hip arthroplasty with hypotensive epidural anesthesia. J Bone Joint Surg Am.1994; 76:341-348
31. Westrich GH, Farrell C, Bono JV, Ranawat CS, Salvati EA, Sculco TP. The incidence of venous thromboembolism after total hip arthroplasty:a specific hypotensive epidural anesthesia protocol. J Arthroplasty.1999; 14:456-463
32. Sharrock NE,Bading B,Mineo R,et al. Deliberate hypotensive epidural anesthesia for patients with normal and low cardiac output. Anesth Analg 1994; 79:899-904
33. Sharrock NE, Beksac B, Flynn E, Go G, Gonzalez Della Valle A.Hypotensive epidural anaesthesia in patients with preoperative renal dysfunction undergoing total hip replacement. Br J Anaesth.2006; 96:207-212.
34. Williams-Russo P, Sharrock NE, Mattis S, Szatrowski TP, Charlson ME. Cognitive effects after epidural vs general anesthesia in older adults:a randomized trial. JAMA.1995; 274:44-50
35. Knight MTN, Dawson R:Effect of intermittent compression of the arms on deep venous thrombosis of the leg. Lancet 1976; 2:1265-1268
36. Macaulay W,Westrich G,Sharrock N,et al. Effect of Pneumatic compression on frbrinolysis after total hip arthroplasty. Clin Orthop Relat Res.2002; 399; 168-176
37. Westrich GH, Specht LM, Sharrock NE, et al.Peterson M.'Pneumatic compression hemodynamics in total hip arthroplasty. Clin Orthop Relat Res.2000; 372:180-191
38. Lachiewicz PF, Soileau ES. Multimodal prophylaxis for THA with mechanical compression. Clin Orthop Relat Res.2006; 453:225-230.
39. Ryan MG, Westrich GH, Potter HG. Effect of mechanicalcompression on the prevalence of proximal deep venous thrombosisas assessed by magnetic resonance venography. J Bone JointSurg Am.2002; 84:1998-2004.
40. Froimson M, Murray TG, Fazekas AF. Venous Thromboembolic Disease Reduction with a Portable Pneumatic Compression Device. J Arthroplasty 2009, 24:310-316
41. allaghan JJ, Dorr LD, and Engh GA, et al. Prophylaxis for thromboembolic disease:recommendations from the American College of Chest Physicians-are they appropriate for orthopaedic surgery? J Arthroplasty 2005; 20:273
42. American Academy of Orthopaedic Surgeons clinical guideline on prevention of symptomatic pulmonary embolism in patients undergoing total hip or knee arthroplasty. Available at http://www.aaos.org/Research/guidelines/guide.asp, 2007.
43. Bek D,Beksac B,Gonzalez Della Valle A,et al:Aspirin decrease the prevalence and severity of heterotopic ossification after 1-stage bilateral total hip arthroplasty for osteoarthrosis.J Arhtroplasy 2009,24:226-232
44. Eikelboom JW, Karthikeyan G, Fagel N. American Association of Orthopedic Surgeons and American College of Chest Physicians Guidelines for Venous Thromboembolism Prevention in Hip and Knee Arthroplasty Differ What Are the Implications for Clinicians and Patients? Chest.2009 Feb; 135(2):513-20
45. Markel DC,York S,Liston MJ,et al. Venous thromboembolism management by American Association of Hip and Knee Surgeons. J Arthroplasty 2010,25,1:3-9
46. Pulmonary Embolism Prevention (PEP) Trials Collaborative Group. Prevention of pulmonary embolism and deep vein thrombosis with low dose aspirin: pulmonary embolism prevention (PEP) trial. Lancet 2000; 355(9212):1295-302.
47. Collaborative overview of randomized trials of antiplatelet therapy:Ⅲ. Reduction in venous thrombosis and pulmonary embolism by ant platelet prophylaxis among surgical and medical patients:Antiplatelet Trialists Collaboration.BMJ 1994; 308:235-246.
48. Lotke PA, Lonner JH:The benefit of aspirin chemoprophylaxis for thromboembolism after total knee arthroplasty. Clin Orthop Relat Res 2006; 452: 175-180.
49. Eikelboom JW, Quinlan DJ, Douketis JD. Extended-duration prophylaxis against venous thromboembolism after total hip or knee replacement:a meta-analysis of the randomised trials. Lancet 2001; 358(9275):9-15.
50. Col well CW Jr, Collis DK, Paulson R, et al. Comparison of enoxaparin and warfarin for the prevention of venous thromboembolic disease after total hip arthroplasty. Evaluation during hospitalization and three months after discharge. J Bone Joint Surg Am 1999; 81(7):932-40.
51. rancis CW, Berkowitz SD, Comp PC, et al. Comparison of ximelagat-ran with warfarin for the prevention of venous thromboembolism after total knee replacement. N Engl J Med 2003,349:1703-1712
52. Hull RD,Pineo GF,Francis C,et al.Timing of intial administration of low-molecular-weight heparin prophylaxis using dalteparin in close proximity to surgery vs warfarin in hip arthroplasty patients:A double-blind,randomized comparison.The North American Fragmin Trial Investigators.Arch Intern Med 2000,160:2199-2207
53. Callaghan JJ, Dorr LD, Engh GA, et al:prophylaxis for thromboembolic disease. J Arthroplasty 2005,20:273-274
54= Freedman KB, Brookenthal KR, Fitzgerald RH, et al:A meta-analysis of thromboembolic prophylaxis following elective total hip arthroplasty.J Bone Joint Surg Am 2000, A82:929-938
55. Lieberman J R, John W, Frederick D, et al. The Efficacy of Prophylaxis with Low-Dose Warfarin for Prevention of Pulmonary Embolism following Total Hip Arthroplasty. J Bone Joint Surg [Am] 1997; 79-A; 319-25
56. Francis CW, Pellegrini VD Jr, Totterman S, et al:Prevention of deep-vein thrombosis after total hip arthroplasty:Comparison of warfarin and dalteparin. J Bone Joint Surg Am 1997; 79:1365-1372.
57. Francis CW, Pellegrini VD Jr, MarderVJ, et al:Comparison of warfarin and external pneumatic compression inprevention of venous thrombosis aftertotal hip replacement. JAMA 1992; 267:2911-2915.
58. Pellegrini VD Jr. Warfarin prophylaxes for orthopaedic venous thromboembolic disease. Instr Course Lect.2002; 51:491-8.
59. Pellegrini VD Jr, Donaldson CT, Farber DC, Lehman EB, Evarts CM. Prevention of readmission for venous thromboembolic disease after total hip arthroplasty. Clin Orthop Relat Res.2005; 441:56-62.
60. Pellegrini VD Jr, Donaldson CT, Farber DC, Lehman EB, Evarts CM. Prevention of readmission for venous thromboembolism after total knee arthroplasty. Clin Orthop Relat Res.2006; 452:21-7.
61. Lieberman J R, Barnes CL, Lachiewicz P F., Hanssen A D., Clarke H D, Pellegrinit VD Jr. Venous Thromboembolism Debate in Joint Arthroplasty. J Bone Joint Surg Am.2009; 91:29-32.
62. Lassen MR, Davidson BL, Gallus A, et al. The efficacyand safety of apixaban, an oral, direct factorXa inhibitor, as thromboprophylaxis in patientsfollowing total knee replacement. J Thromb Haemost 2007; 5(12):2368-75.
63. Lassen MR, Raskob GE, Gallus A, et al. T Apixaban or Enoxaparin for Thromboprophylaxis after Knee Replacement. N Engl J Med 2009; 361:594-604.
64. Kakkar AK, Brenner B, Dahl OE, et al. Extended duration rivaroxaban versus short-term enoxaparin forthe prevention of venous thromboembolism after total hip arthroplasty:a double-blind, randomised controlled trial. Lancet 2008; 372:31-39.
65. Lazo-Langner A, Rodger MA, Wells PS. Lessonsfrom ximelagatran. Issues for future studies evaluating new oral direct thrombin inhibitors for venousthromboembolism prophylaxis in orthopedic surgery. Clin Appl Thromb Hemost, in press.
66. Bae H, Westrich GH, Sculco TP, Salvati EA, Reich LM. The effect of preoperative donation of autologous blood on deep-vein thrombosis after total hip arthroplasty. J Bone Joint Surg Br.2001; 83:676-679.
67. Sharrock N, Go G, Mayman D, Sculco TP. Decreases in pulmonary artery oxygen saturation during total hip arthroplasty:variations using two leg positioning techniques. J Arthroplasty.2005; 20:499-502.
68. Salvati EA, Gonzalez Della Valle A. Thromboembolism following total hip replacement. J Long Term Eff Med Implants.2003; 13:325-340.
69. Salvati EA, Gonzalez Della Valle A, Westrich GH, Rana AJ, Specht L, Weksler BB, Wang P, Glueck CJ. The John Charnley Award:heritable Thrombophilia and Development of Thromboembolic Disease after total hip arthroplasty. Clin Orthop Relat Res.2005; 441:40-55.
70. Salvati EA, Lachiewicz P. Thromboembolism following total hip replacementarthroplasty:the efficacy of dextran-aspirin and dextran-warfarin in prophylaxis. J Bone Joint Surg Am.1976; 58:921-925.
71. Salvati EA, Pellegrini VD Jr, Sharrock NE, Lotke PA, Murray DW, Potter H, Westrich GH. Recent advances in venous thromboembolic prophylaxis during and after total hip replacement. J Bone Joint Surg Am.2000; 82:252-270.
72. Eduardo A.Salvati, Nigel F.Sharrock, Geoffrey Westrich, et al. The 2007 ABJS Nicolas Andry Award:three decades of linical,basic,and applied research on thromboembolic disease after THA. Clin Orthop Relat Res 2007; 459:246-254
73. Gonzalez Della Valle A, Reynoso FJ, Ari JB, Salvati E. The multimodal approach for the prevention of thromboembolic disease after total joint arthroplasty. Seminars in Arthroplasty 2009,20,4:241-250
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