摘要
目的分析外科术后静脉血栓栓塞症发生现状并探讨术后发生静脉栓塞的影响因素,为相关防治工作提供参考资料。方法将2019年1月至2020年12月攀枝花某医院外科术后患者作为研究对象,收集患者基本信息、手术相关资料并进行术前生理生化指标检测,分别于术后24、48、72 h内各进行1次静脉血栓检测。采用描述流行病学分析方法对结果进行分析,并采用单、多因素分析方法对术后静脉血栓栓塞症发生因素进行分析。结果共研究1 370例外科术后患者,静脉血栓栓塞症发生率为7.4%。其中,下肢静脉血栓栓塞症85例(83.3%)、肺动脉栓塞17例(16.7%)。下肢静脉血栓栓塞症以左下肢多见(69.4%),常见症状为肿胀、疼痛、浅静脉曲张。肺动脉栓塞常见症状为呼吸困难和气促、胸痛。多因素分析结果显示年龄越大(OR=1.239)、合并基础疾病者(OR=1.351)、开放手术(OR=2.268)、手术时间≥60 min(OR=1.496)、术后D-二聚体水平≥500μg/L(OR=2.869)、术后卧床时间≥24 h(OR=3.136)是外科术后患者发生静脉血栓栓塞的危险因素,应用预防性抗凝药物(OR=0.710)是发生外科术后静脉血栓栓塞的保护因素。结论术后静脉血栓栓塞症的发生以下肢静脉血栓栓塞症为主,受到年龄、手术方法、手术时间、术后D-二聚体水平、术后卧床时间、应用预防性抗凝药物等多因素影响,应当引起重视,对于高危患者加强干预,减少术后静脉血栓栓塞症发生。
Objective To analyze the occurrence of postoperative venous thromboembolism and explore its influencing factors,so as to provide reference for related prevention and treatment.Methods Taking patients after surgery in a hospital in Panzhihua from January 2019 to December 2020 as the research object,collecting the basic information and surgery-related data,and performing preoperative physiological and biochemical index tests. Venous thrombosis was detected once within 24,48 and 72 hours after operation. Descriptive epidemiological analysis method was used to analyze the results,and univariate and multivariate analysis methods were used to analyze the influencing factors of postoperative venous thromboembolism.Results A total of 1 370 postoperative patients were studied. The incidence of venous thromboembolism was 7.4%. Among them,there were 85 cases of lower extremity venous thromboembolism(83.3%)and 17 cases of pulmonary embolism(16.7%). Venous thromboembolism of lower extremity was common in the left lower extremity(69.4%),with common symptoms of swelling,pain and varicose vein. The common symptoms of pulmonary embolism were dyspnea,shortness of breath and chest pain. The results of multivariate analysis showed that the older the age(OR=1.239),the patients with underlying diseases(OR=1.351),the open surgery(OR=2.268),the operation time ≥60 min(OR=1.496),the postoperative D-dimer level ≥500 μg/L(OR=2.869),and postoperative bedridden time ≥24 h(OR=3.136)were risk factors for venous thromboembolism in patients after surgery. The use of preventive anticoagulants(OR=0.710)was a protective factor for venous thromboembolism in patients after surgery.Conclusion The postoperative venous thromboembolism is mainly lower extremity venous thromboembolism,which is affected by many factors,such as age,operation method,operation time,postoperative D-dimer level,postoperative bedridden time,application of preventients to reduce the incidence of postoperative venous thromboembolism.
作者
吴国芳
潘艳
刘爱芬
杨丛莲
WU Guo-fang;PAN Yan;LIU Ai-fen;YANG Cong-lian(Affiliated Hospital of Panzhihua University,Panzhihua 617000,China)
出处
《华南预防医学》
2021年第9期1123-1126,共4页
South China Journal of Preventive Medicine
基金
攀枝花市科技局2017社会发展项目(2017CY-S-6-2)。
关键词
外科
术后
静脉血栓栓塞症
下肢静脉血栓
肺动脉栓塞
影响因素
Surgery
Postoperative
Venous thromboembolism
Lower extremity venous thrombosis
Pul-monary embolism
Influencing factor
