摘要
目的探讨下肢骨折术后深静脉血栓(DVT)形成危险因素。方法收集2012年1月1日-2015年12月31日因下肢骨折在新疆医科大学第一附属医院接受手术治疗患者的围手术期临床资料,以术后2w内是否发生DVT分为血栓组和非血栓组,对围术期各相关因素进行单因素和多因素Logistic回归分析以筛选出独立危险因素。结果 228例患者中下肢骨折术后2w内发生DVT94例(41.2%),非DVT134例(58.8%),男性138例(60.5%),女性90例(39.5%),胫腓骨73例(32.0%),膝关节28例(12.3%),股骨干16例(7.0%),股骨颈41例(18.0%),转子间39例(17.1%),踝关节31例(13.6%)。两组患者糖尿病病史和术后感染差异有统计学意义。单因素Logistic回归分析显示两组体重指数(BMI)、糖尿病病史、术后感染、血小板计数(PLT)、平均血小板体积(MPV)、D-二聚体(D-D)、术后使用抗凝药物(UAT)差异均有统计学意义。多因素Logistic回归分析结果显示:糖尿病病史、PLT、MPV、D-D为术后2w内发生DVT的独立危险因素,其OR值分别为1.69、1.95、1.49、2.16;而术后UAT为术后2w内DVT形成的独立保护因素,其OR值为0.18,两组之间差异有统计学意义(P<0.05)。结论下肢骨折术后2~5a的PLT、MPV、D-D可有效预测术后2w内DVT的形成,对于高危人群有效抗凝治疗可预防术后DVT的发生。
Objective To discuss the relevant risk factors of deep vein thrombosis （DVT） in patients associ-ated fracture of lower limb after surgery. Methods Clinical information of patients with fracture of lower limb who received surgery in our hospital from Jan. 2012 to Dec. 2015 were enrolled and were divided into DVT group and non DVT group according to the incidence of DVT in two weeks after surgery, then using one-way ANOVA and multiple Logistic regression analysis to analyze the peri-operative relevant factors in order to sort out the independent risk factors. Results 228 patients associated fracture of lower limb in two weeks after surgery have incidence of 94 DVT （41.2%） , 134 non-DVT （58.8%） , 138 male （60.5%）, 90 female （39.5%） , 73 tibiofibula （32.0%）, 28 knee joint （12.3%）, 16 shaft of femur （7.0%）, 41 col-umn femurs （18.0%） , 39 intertrochanter （17.1%） , 31 ankle （13.6%） , there was significant difference be-tween two groups of diabetes and postoperative infection. One-way Logistic regression analysis showed that there was also significant difference between two groups in terms of Body Mass Index （BMI） , diabe-tes,postoperative infection,platelet count （PLT） , mean platelet volume （MPV） D-Dimer （D-D） and us-age of anticoagulation therapy （UAT）. Multiple Logistic regression analysis showed that diabetes, PLT, MPV and D-D were found to be independent risk factors of the incidence of DVT in two weeks after sur-gery, their OR value were 1. 69, 1.95, 1.49, 2.16, respectively; the independent protective factor was UAT, its OR value was 0.18, there was significant differnece between the two groups （P 〈0.05）. Conclu-sions Our study showed that PLT, MPV, D-D in 2-5 days after surgery could predict the incidence of DVT in two weeks after surgery, the effective anticoagulation therapy related to high risk group could pre-vent the incidence of DVT after surgery .
出处
《新疆医科大学学报》
CAS
2017年第7期876-879,884,共5页
Journal of Xinjiang Medical University
基金
国家自然科学基金(81660368)
关键词
下肢骨折
深静脉血栓
独立危险因素
LOGISTIC回归模型
Fracture of lower limb
Deep vein thrombosis
the independent risk factors
the logistic regres-sion model
