摘要
目的:探讨中青年创伤骨折患者围手术期下肢深静脉血栓(DVT)发生的高危因素。方法:采用回顾性研究,将筛选出的153例中青年(18~50岁)创伤骨折患者,根据超声诊断将患者分为DVT组和非DVT组,对年龄,性别,伤后时间,DVT发生时间,手术前后D-二聚体(D-dimer,D-D)的变化等因素对DVT发生的影响因素进行分析。结果:两组患者在年龄和基础疾病的伤存在显著性差异(P<0.001);术前确诊时间,血栓组(6.58±5.38)d,非血栓组(3.85±2.63)d,P<0.001;D-D在血栓组和对照组术前检测时间(2.58±1.94 vs 2.74±1.76,P=0.42)d,术后检测时间(2.88±1.80 vs 2.58±1.94,P=0.40)d,D-D值在术前(6.65±3.35 vs 7.11±9.45,P=0.67)mg·L^(-1),术后(6.58±5.38 vs 5.38±3.97,P=0.19)mg·L^(-1),同一组手术前后D-D值的变化无统计学意义(P>0.05)。结论:年龄和基础疾病依旧是中青年患者DVT发生的高危因素,手术在伤后时间超过4天的创伤性骨折患者,应在术前进行DVT影像学排查和处理,减少手术应激导致血栓脱落的可能,目前仍缺乏有效的实验室方法对创伤性骨折DVT事件的发生进行评估和预测。
Objective： To explore perioperative risk factors of deep vein thrombosis（ DVT） in lower extremity in young and middle-aged patients with trauma fracture. Methods： 153 patients（ 18 to 50 y） with traumatic fracture were included in the retrospective study. According to the ultrasound results,these patients were divided into DVT and non-DVT groups. And such characteristics as age,sex,the time after the injury before surgery,DVT occurrence time,D-dimer（ D-dimer,D-D） before and after surgery were obtained. All these factors were analyzed for the risk factors of DVT. Results： Such characteristics,as age and existing chronic diseases,in these two groups were significantly different（ P〈 0. 001）. Moreover,the preoperative diagnosis time in the thrombus group（ 6. 58 ±5. 38） d and the non-thrombus group（ 3. 85 ± 2. 63） d was also significantly different（ P〈 0. 001）. The preoperative testing time of D-D in D-D group and control group was（ 2. 58 ± 1. 94 vs. 2. 74 ± 1. 76,P = 0. 42）,respectively. The detecting time was（ 2. 88 ± 1. 80 vs. 2. 58 ± 1. 94,P = 0. 40） d,D-D value in preoperative was（ 6. 65 ± 3. 35 vs. 7. 11 ± 9. 45,P = 0. 67） mg·L^-1,it was（ 6. 58 ± 5. 38 vs. 5. 38 ± 3. 97,P = 0. 19） mg L^-1,There was no statistical significance of D-D value changes before and after operation（ P 0. 05）. Conclusion： Age and basic diseases are still DVT risk factors of young and middle-aged patients with trauma fracture surgery. The surgery performed 4 days or more after injury in patients with traumatic fracture should be screened for DVT imaging in order to reduce stress leading to falling thrombosis off; there is yet no effective method to evaluate and forecast DVT caused by traumatic fractures.
出处
《现代医学》
2017年第12期1797-1800,共4页
Modern Medical Journal
基金
陕西省自然科学基金资助(2014JM2-8183)
