下肢及骨盆骨折患者围手术期下肢静脉血栓形成的危险因素分析-现代医学

下肢及骨盆骨折患者围手术期下肢静脉血栓形成的危险因素分析

单位：1. 承德医学院;
2. 承德医学院附属医院创伤骨科, 河北承德 067000

分类号：R683.4;R683.3

出版年·卷·期（页码）：2017·36·第七期（910-915）

摘要：

目的：分析创伤骨折患者围手术期下肢深静脉血栓形成（DVT）的危险因素。方法：选择创伤骨科行手术治疗的患者589例，记录患者的一般情况，骨折情况，手术情况及相关化验检查并进行统计学分析。结果：589例创伤骨折患者中DVT总发生率为15.7%。单因素分析结果显示年龄 > 65岁、体重指数（BMI）≥25 kg·m^-2、有吸烟史、缺乏锻炼、既往有高血压病患者、手术持续时间 > 2小时，术中大量输血及全身麻醉患者DVT的发生率明显增高。不同部位骨折患者下肢静脉血栓的发生率不同。多发骨折患者DVT的发生率高于单处骨折患者。血栓患者的纤维蛋白原，D-二聚体及C-反应蛋白较非血栓患者明显增高。患者创伤后血栓高发时间为伤后1-3天及术后1天，且以下肢肌间静脉血栓为主。随着年龄的增大血栓发生率增加。结论：DVT在创伤骨折患者中具有较高的发生率，DVT的发生与患者一般情况、创伤部位、手术因素及实验室指标等相关，临床医生需提高警惕，尽早采取预防措施。

Objective: To explore the risk factors contributing to deep vein thrombosis(DVT) in the orthopaedic surgery perioperative period. Methods: Among 589 cases of surgical treatment, the general situation of the patients, fracture, operation and related laboratory tests were recorded and performed statisticallyanalyzed. Results: The total incidence rate of DVT in 589 patients was 11.99%.The univariate analysis showed that male patients with age>65 years, body mass index(BMI)>25 kg·m^-2,history of smoking,lack of exercises,history of diabetes hypertensive had a higher incidence of thrombosis,and the incidence of DVT was significantly increased in patients with a large amount of blood transfusion and general anesthesia during >2 hours. In different injury types,The incidence of lower extremity venous thrombosis was different in different parts of fracture patients. The incidence of DVT in patients with multiple fractures was higher than that in patients with single fractures. Fibrinogen, D-dimer and C-reactive protein were significantly increased in patients with thrombosis. The time of high incidence of thrombosis in patients was 1-3 days and 1 days after operation. The incidence of thrombosis increased with age. Conclusion: DVT in traumatic fracture is of high incidence, the depending on the general condition of patients, trauma, surgery and other related factors and laboratory indicators. Doctors need to be vigilant and take preventive measures as soon as possible.

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