摘要
目的研究老年髋关节骨折(hip fracture,HF)患者围手术期下肢深静脉血栓(deep venous thrombosis,DVT)的影响因素。方法选择2015年1月—2017年12月于电子科技大学医学院附属肿瘤医院治疗的HF老年患者178例,男性98例(55.06%),女性80例(44.94%);年龄62~81岁,平均71.6岁;致伤原因:摔伤97例,道路交通伤56例,坠落伤18例,其他7例。依据是否发生DVT分为DVT组(n=59)与无DVT组(n=119),比较两组性别、年龄、BMI、ISS评分、骨折至手术时间、手术时间、应用抗凝药物比例,并对危险因素行Logistic回归分析。结果 DVT组男女比例(54.24%vs.45.76%)、BMI与无DVT组男女比例(55.46%vs.44.54%)、BMI差异无统计学意义(P>0.05);DVT组各合并疾病发生率均高于无DVT组各合并疾病发生率(P<0.05)。DVT组年龄、ISS评分、骨折至手术时间、手术时间均大于无DVT组(P<0.05)。DVT组应用抗凝药物比例(76.27%)高于无DVT组(57.14%,P<0.05)。使用抗凝药物患者DVT发生率(20.54%)低于未使用抗凝药物患者(37.88%,P<0.05)。行Logistic回归分析发现,年龄≥60岁、ISS评分≥30分、骨折至手术时间≥3d、手术时间≥4h、使用抗凝药物等均为老年HF患者围术期DVT形成的独立危险因素(P<0.05)。结论年龄≥60岁、ISS评分≥30分、骨折至手术时间≥3d、手术时间≥4h、未使用抗凝药物等均为老年HF患者围术期DVT形成的独立危险因素。
Objective To study the influence factors of lower limb deep venous thrombosis（DVT） on senile patients with hip fracture（HF） during perioperative period. Methods A total of 178 senile patients （98 males and 80 females with an average of 71.6 （62-81） years） with HF hospitalized from Jan. 2015 to Dec. 2017 in our hospital were selected and divided into two groups according to the occurrence of DVT： DVT group （59 cases） and non-DVT group （119 cases）. Totally 97 were injured from falling,56 were from road traffic accidents,18 were from high falling and 7 were from other causes. The gender,age,BMI,ISS,time from fracture to operation,operation time and ratio of anticoagulant drugs between the two groups were compared between the two groups,and the risk factors were analyzed by Logistic regression. Results Gender ratio of DVT group was 54.24% for male and 45.76% for female and that of non-DVT group was 55.46% for male and 44.54% for female, and there was no significant difference in BMI between the two groups（ P 〉0.05）. The complication incidence of DVT group was higher than that of non-DVT group（ P 〈 0.05）; patients in DVT group were older than those in non-DVT group; ISS score of DVT group was higher than that of non-DVT group,and interval time from fracture to operation and operation time of DVT group were both longer than those of non-DVT group （ P 〈 0.05）. The proportion of anticoagulant drug application in DVT group was 76.27%,which was higher than that of non-DVT group of 57.14%（ P 〈 0.05）. The incidence of DVT in patients given anticoagulant drugs was 20.54%,which was lower than that of patients without anticoagulants of 37.88%（ P 〈 0.05）. After Logistic regression analysis was applied,the following were observed to be independent risk factors of DVT for senile HF patients during perioperative period：age of 60 years or older,ISS score of more than 30,interval time from fracture to operation of no less than 3 days,the operation time of no less than 4 hou
作者
李桂芳
邓大群
唐红华
LI Gui-fang,DENG Da-qun,TANG Hong-hua(Department of Anaesthesiology,Cancer Hospital Affiliated to School of Medicine,University of Electronic Science and Technology of China,Sichuan Cancer Hospital ＆ Institute,Sichuan Cancer Center,Chengdu 610041,Chin)
出处
《创伤外科杂志》
2018年第8期608-611,共4页
Journal of Traumatic Surgery
关键词
髋关节骨折
围手术期
下肢静脉血栓
老年
hip fracture
perioperative period
lower limb venous thrombosis
elderly
