title: [Early diagnosis of lower limb deep vein thrombosis after major orthopedic surgeries].
abstract: OBJECTIVE
  To investigate the early diagnosis of lower limb deep vein thrombosis (DVT) after major orthopedic surgeries.
  
  
  METHODS
  From October 2005 to June 2009, color doppler sonography and hemorheology detection were carried out for 62 cases undergoing first total hip arthroplasty (THA), 14 cases undergoing total knee arthroplasty (TKA), and 86 cases undergoing hip fractures surgery (HFS) before operation and 1, 7, 14 days after operation. The plasma D-dimer levels of the DVT were also examined for the THA patients before operation and 3 days after operation. Of all cases, there were 89 males and 73 females, aged from 34 to 74 years (51.5 years on average). After operation, all the patients were treated with the regular low molecular weight heparin sodium against DVT.
  
  
  RESULTS
  After operation, 17 cases (10.5%) developed DVT, including 8 THA cases, 1 TKA case, and 8 HFS cases. Preoperative color doppler sonography showed no abnormal echo, normal strong blood flow signal, and normal periodical variation in vein blood flow without regurgitation. Postoperative examinations showed that the vascular occlusion of common femoral vein and popliteal vein occurred in DVT patients. There were significant differences (P < 0.05) in whole blood viscosity between patients with DVT and without DVT after 1, 14 days and no significant difference (P > 0.05) before operation and 7 days after operation. There was no significant difference (P > 0.05) in plasma viscosity and erythrocyte aggregation index, between patients with DVT and without DVT pre- and postoperation. There was significant difference (P < 0.05) in erythrocyte deformation index between patients with DVT and without DVT 14 days after operation. The preoperative plasma D-dimer levels of patients with DVT and without DVT were (372.00 +/- 148.62) ng/mL and (369.00 < or = 141.03) ng/mL, respectively, showing no significant difference (P > 0.05); the 3 days postoperatively levels were (574.00 +/- 217.29) ng/mL and (391.00 +/- 120.16) ng/mL, respectively, showing significant difference (P < 0.05).
  
  
  CONCLUSIONS
  Color doppler sonography in combination of hemorheology and plasma D-dimer examination can be beneficial for the early diagnosis of DVT in major orthopedic surgeries.
authors.affiliation: Department of Orthopedics, Yiwu Chouzhou Hospital, Yiwu Zhejiang, 322000, P.R. China.
authors.forename: Ren
authors.initials: R
authors.lastname: Zhu
authors.forename: Shejun
authors.initials: S
authors.lastname: Wei
authors.forename: Siwang
authors.initials: S
authors.lastname: Wu
authors.forename: Haiying
authors.initials: H
authors.lastname: Gong
authors.forename: Xianzhong
authors.initials: X
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D042241:Early Diagnosis; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D018056:Hemorheology; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000009:adverse effects*; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D018615:Ultrasonography, Doppler, Color; D020246:Venous Thrombosis / Q000000981:diagnostic imaging* / Q000209:etiology
chemical_list: D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D