超声弹性成像辅助评价跟骨骨折手术等待期急性深静脉血栓的发生危险

发布时间：2018-03-16 19:17

本文选题：跟骨　切入点：骨折　出处：《中国组织工程研究》2017年03期 　论文类型：期刊论文

【摘要】：背景:跟骨骨折术前等待期发生深静脉血栓影响骨折预后,因此,对其准确诊断具有重要的临床意义。目前,关于跟骨骨折术前等待期血栓分期研究罕见报道。目的:利用超声弹性成像技术,对血栓病例进行分期诊断,探究跟骨骨折手术等待期患者深静脉血栓的发生率及其危险因素。方法:自2008至2015年从青海大学附属医院跟骨骨折住院患者中招募符合标准的研究对象入组,于术前行彩色多普勒超声检查,诊断有血栓形成的患者再行超声弹性成像分期诊断,统计血栓发生率,根据病历记录收集研究对象年龄、性别、体质量指数、吸烟史等因素分布,利用多重Logistics回归分析血栓形成与上述因素相关性。结果与结论:(1)最终招募149例跟骨骨折患者,共有22例患者出现下肢深静脉血栓,发生率为14.8%,急性血栓的发生率为9.4%;(2)多重Logistic回归结果提示,年龄(P=0.009,OR值=1.063,95%可信区间为1.010-1.117)、体质量指数(P=0.019,OR值=1.302,95%可信区间为1.124-1.430)、吸烟史(P=0.017,OR值=5.124,95%可信区间为1.347-18.359)、手术等待期时间(P=0.000,OR值=5.190,95%可信区间为1.396-19.266)等因素为急性下肢深静脉血栓的危险因素;(3)结果表明,跟骨骨折手术等待期患者下肢深静脉血栓发生率较高,急性血栓占较大比例。需根据患者年龄、吸烟史、体质量指数以及手术等待期时间等因素评估急性深静脉血栓发生的危险,给予以相应的诊治方案。
[Abstract]:Background: the occurrence of deep venous thrombosis in the preoperative waiting period of calcaneal fracture affects the prognosis of the fracture. Therefore, it is of great clinical significance to accurately diagnose the fracture. At present, A rare report on the staging of thrombus before operation for calcaneal fracture was reported. Objective: to make staging diagnosis of thrombus in patients with calcaneal fracture by using the technique of ultrasonic elastic imaging. Objective: to investigate the incidence and risk factors of deep venous thrombosis in patients with calcaneal fracture in waiting period. Methods: from 2008 to 2015, subjects who met the criteria were recruited from patients with calcaneal fracture in Qinghai University affiliated Hospital. Color Doppler ultrasonography was performed before operation, and the patients with thrombus were re-diagnosed by ultrasonic elastic imaging stages, the incidence of thrombus was counted, and the age, sex, body mass index of the subjects were collected according to the records of medical records. Multiple Logistics regression analysis was used to analyze the relationship between thrombosis and the above factors. Results and conclusion: 149 patients with calcaneal fracture were recruited and 22 patients developed deep venous thrombosis of lower extremity. The incidence rate of 14. 8% and the incidence of acute thrombus were 9. 4% and 9. 4% respectively. The results of multiple Logistic regression showed that, The odds ratio (OR) was 1.010-1.117%, the BMI was 1.30295% (1.124-1.430), the OR value of smoking history was 5.124 ~ (95%) (1.347-18.359), the OR of waiting time was 5.19095% (1.396-19.266) and the other factors were the risk factors of acute thromboembolism of the lower extremity (P = 1.396-19.266), and the odds ratio (OR) was 1.347-18.359. the odds ratio (OR) was 1.396-19.266.The results showed that the risk factors of acute thromboembolism were as follows: (1) the risk factor of acute thrombus was 1.396-19.266 (P = 1.396-19.266), and the mean odds ratio (OR) was 1.347-18.359% (P = 1.347-18.359). The incidence of deep venous thrombosis of lower extremity in patients with calcaneal fracture in waiting period was higher than that in patients with acute thrombosis. Body mass index (BMI) and waiting time were used to evaluate the risk of acute deep venous thrombosis (DVT).
【作者单位】：青海大学附属医院创伤骨科;
【分类号】：R687.3;R543.6

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