摘要
目的分析康复医学科住院脑出血患者并发下肢深静脉血栓(DVT)的危险因素。方法回顾性分析2015年8月至2017年8月中国科学技术大学附属第一医院(安徽省立医院)康复医学科收治的脑出血患者230例,人院时完善凝血象、D-二聚体及瘫痪侧下肢静脉彩超检查。根据下肢静脉彩超表现,分为伴DVT组(31例)和不伴DVT组(199例);记录2组患者的性别、年龄、病程、瘫痪侧别、意识状况、是否气管切开、有无并发症(肺部感染、尿路感染、压疮等)、有无异物置入、有无深静脉置管史、心率是否大于100次/分、此次发病后有无康复干预、瘫痪侧下肢肌张力状况、瘫痪侧下肢有无主动活动、瘫痪侧下肢有无肿胀、入院时D一二聚体及纤维蛋白原数值等临床因素。先采用单因素分析,再进行多因素logistic回归分析,筛选脑出血并发DVT的危险因素。结果单因素分析显示,年龄、性别、病程、气管切开、尿路感染、压疮、异物置人、下肢肿胀和下肢肌张力等因素可能与脑出血患者DVT发生有关(P<O.05);回归分析显示,下肢肿胀[OR=20.624,95%CI=(2.033~209.263),P=0.010]和下肢肌张力低下[OR=9.956,95%CI=(2.699~36.735),P=0.001]与脑出血患者DVT发生有关。结论下肢肿胀和下肢肌张力低下是脑出血患者并发DVT的独立危险因素。
Objective To explore the risk factors for deep vein thrombosis (DVT) of the lower extremity among patients hospitalized after a cerebral hemorrhage. Methods A total of 230 patients with cerebral hemorrhage admitted between August 2015 to August 2017 were retrospectively analyzed. At admission, each was were given a coagulogram, D-dimer and color Doppler ultrasound of the lower extremity. The patients were divided into a DVT group (31 cases) and a non-DVT group (199 cases) according to the color Doppler ultrasound results. The following clinical information was recorded: sex, age, disease course, paralysis side, consciousness, tracheotomy, complications (pulmonary infection, urinary tract infections and pressure sores), foreign matter implanting, history of venous catheterization, heart rate over 100 beats/min or not, rehabilitation intervention after the onset, muscle tension in the lower extremity, activity and swelling on the paralysis side, and the serum levels of D-dimer and fibrinogen. Univariate and multivariate logistic regression was applied in search of useful risk factors. Results The univariate analysis showed that age, gender, disease course, tracheotomy, urinary tract infections, pressure sores, foreign matter implanting, and swelling and muscle tension in the lower extremity were all associated with the occurrence of DVT among these cerebral hemorrhage patients. According to the results of the multivariate logistic regression analysis, swelling and muscle tension in the lower extremity were related with the occurrence of DVT for those patients. Conclusion Swelling and muscle tension in a lower extremity are independent risk factors for the occurrence of DVT after a cerebral hemorrhage.
作者
穆景颂
倪朝民
吴鸣
刘郑
Mu Jingsong;Ni Chaomin;Wu Ming;Liu Zheng(Department of Rehabilitation Medicine,The First Affiliated Hospital of University of Science and Technology of China,Hefei 230001,China)
出处
《中华物理医学与康复杂志》
CAS
CSCD
北大核心
2018年第12期906-909,共4页
Chinese Journal of Physical Medicine and Rehabilitation
关键词
脑出血
深静脉血栓形成
下肢
危险因素
Cerebral hemorrhage
Deep vein thrombosis
Lower extremities
Risk factors
