摘要
目的以“时间-事件”的方式分析老年患者腰椎术后深静脉血栓(deep vein thrombosis,DVT)发生的情况,为腰椎术后DVT的防治提供数据支持。方法选择2013年9月~2019年6月在本院接受腰椎手术的428例患者作为研究对象,术后观察DVT发生人数、DVT发生时间,以K-M曲线观察DVT发生的时间曲线,以Cox风险模型观察影响DVT发生的风险因素和DVT发生的生存函数。结果428例患者12周内共发生DVT 47例,发生率为10.98%,有典型临床症状与体征者16例,占34.04%。总的生存曲线表明,多数DVT事件发生于术后第1周,其次是术后第2周。单因素分析显示,DVT和非DVT患者的年龄、高血压、融合手术、手术时间、纤维蛋白原(fibrinogen,FIB)、D-二聚体(D-dimer,D-D)、低密度脂蛋白(low density lipoprotein,LDL)、总胆固醇(total cholesterol,TC)等临床指标存在统计学差异(P<0.05)。Cox回归模型结果显示,年龄、高血压、D-D是影响DVT发生的风险因素(P<0.05)。Cox回归生存函数显示,多数DVT事件发生在脊柱手术后的第1周和第2周。结论老年腰椎手术患者术后DVT事件多数发生于术后第1周和第2周,多数患者DVT以无症状类型存在,术后2周内应常规对患者进行下肢超声检查,以早期发现无症状型DVT并尽早干预,避免肺栓塞的发生。
Objective To analyze the occurrence of deep vein thrombosis(DVT)in elderly patients with lumbar surgery in a"time event"manner,so as to provide data support for the prevention and treatment of DVT after lumbar surgery.Methods From September 2013 to June 2019,428 patients who underwent lumbar surgery in our hospital were selected in the research.The number and time of DVT were observed postoperatively.The time curve of DVT occurrence was observed by K-M curve.The risk factors and survival function of DVT were observed by Cox risk model.Results There were 47 cases of DVT in 428 patients within 12 weeks,the incidence rate was 10.98%,16 cases had typical clinical symptoms and signs,accounting for 34.04%.The overall survival curve showed that most DVT events occurred in the first week,followed by the second week.Univariate analysis showed that there were significant differences in age,hypertension,fusion surgery,operation time,fibrinogen(FIB),D-Dimer(D-D),low density lipoprotein(LDL),total cholesterol(TC)between DVT and non DVT patients(P<0.05).Cox regression model showed that age,hypertension and D-D were risk factors of DVT(P<0.05).Cox regression survival function showed that most DVT events occurred at 1 and 2 weeks after spinal surgery.Conclusion Most of the DVT events occurred in the first week and the second week after the operation in elderly patients with lumbar surgery.Most patients with DVT are asymptomatic.Ultrasound examination of lower limbs should be routinely performed in 2 weeks after operation to detect asymptomatic DVT early and intervene as soon as possible to avoid the occurrence of pulmonary embolism.
作者
李阳
肖辉
贺占坤
任洋良
LI Yang;XIAO Hui;HE Zhan-kun;REN Yang-liang(Department ofOrthopedics,the First People's Hospital of Xinxiang,Xinxiang,Henan 453000,China;The First People's Hospital of Jintang County,Jintang Hospital of West China Hospital of Sichuan University,Chengdu,Sichuan 610400,China)
出处
《颈腰痛杂志》
2021年第1期8-11,共4页
The Journal of Cervicodynia and Lumbodynia
基金
宁夏回族自治区自然科学基金(编号:NZ16212)。
关键词
腰椎手术
下肢深静脉血栓
时间-事件分析
lumbar surgery
deep venous thrombosis of lower extremity
time event analysis
