摘要
目的探讨脊柱损伤患者术前下肢深静脉血栓形成(deep vein thrombosis,DVT)的发生率及其危险因素。方法选取2018年1月-2019年6月本院诊治的脊柱损伤患者216例,术前均行下肢静脉超声检查,记录DVT发生率;收集患者临床资料,采用多因素Logistic回归分析探讨脊柱损伤患者术前发生下肢DVT的危险因素。结果216例中,术前共40例发生下肢DVT(DVT组),176例未发生下肢DVT(对照组),下肢DVT发生率为18.52%;DVT组合并高血压比率(55.00%)、高脂血症比率(45.00%)、ASIA分级A-B比率(10.00%)、有大血管粥样硬化比率(42.50%)、受伤至超声检查时间≥7 d比率(55.00%)及血清D-二聚体[(6.26±1.25)mg/L]水平均显著高于对照组[19.89%、5.69%、1.73%、20.45%、29.55%、(2.19±1.08)mg/L],红细胞比容[(34.28±5.22)%]显著低于对照组[(36.89±6.16)%](P<0.05),年龄、性别比例、BMI等与对照组差异无统计学意义(P>0.05);多因素Logistic回归分析结果显示,有高脂血症(OR=2.08,95%CI:1.36-3.79,P=0.000)、ASIA分级A-B级(OR=1.27,95%CI:1.12-1.78,P=0.012)、受伤至超声检查时间≥7 d(OR=1.87,95%CI:1.32-3.89,P=0.000)、血清D-二聚体升高(OR=1.55,95%CI:1.13-2.38,P=0.000)是脊柱损伤患者术前发生下肢DVT的危险因素。结论脊柱损伤患者术前下肢DVT发生率较高,合并内科疾病(高脂血症)、脊髓损伤(ASIA分级A-B级)、受伤至超声检查时间(≥7 d)、血清D-二聚体升高可增加其发生风险。
Objective To investigate the incidence and risk factors of deep vein thrombosis(DVT)in patients with spinal injury before operation.Methods A total of 216 patients with spinal cord injury were enrolled in our hospital from January 2018 to June 2019.All patients underwent venous ultrasonography of the lower extremities before surgery to record the incidence of DVT.The clinical data were collected and multivariate Logistic regression analysis was used to analyze the risk factors for lower extremity DVT in patients with spinal injury.Results Of the 216 patients with spinal injury,40 cases had lower extremity DVT(DVT group),176 cases had no lower extremity DVT(control group),and the incidence rate of lower extremity DVT was 18.52%.The ratios of patients complicated with hypertension(55.00%),hyperlipidemia(45.00%),ASIA grade A-B(10.00%),macrovascular atherosclerosis(42.50%),injury to ultrasound examination time≥7 d(55.00%)and serum level of D-dimer[(6.26±1.25)mg/L]in DVT group were significantly higher than those in the control group[19.89%,5.69%,1.73%,20.45%,29.55%,(2.19±1.08)mg/L],the hematocrit[(34.28±5.22)%]was lower than the control group[(36.89±6.16)%](P<0.05).The age,sex ratio,BMI,etc.had no significant differences between the two groups(P>0.05).The results of multivariate Logistic regression analysis showed that hyperlipidemia(OR=2.08,95%CI:1.36-3.79,P=0.000),ASIA grade A-B(OR=1.27,95%CI:1.12-1.78,P=0.012),injury to ultrasound examination time≥7 d(OR=1.87,95%CI:1.32-3.89,P=0.000),increased serum D-dimer level(OR=1.55,95%CI:1.13-2.38,P=0.000)were the risk factors for lower extremity DVT before operation in patients with spinal injury.Conclusion The incidence of DVT in the lower extremity is high in patients with spinal injury before operation,and medical diseases(hyperlipidemia),spinal cord injury(ASIA grade A-B),injury to ultrasound examination time(≥7 d),serum D-dimer elevation can increase the risk of its occurrence.
作者
李雪
LI Xue(The Second Affiliated Hospital of Harbin Medical University,Harbin,Heilongjiang 150000,China)
出处
《颈腰痛杂志》
2020年第4期400-404,共5页
The Journal of Cervicodynia and Lumbodynia
基金
黑龙江省自然科学基金(编号:D00-28)。
关键词
脊柱损伤
脊髓损伤
深静脉血栓形成
下肢
spinal injury
spinal cord injury
deep vein thrombosis
lower limbs
