髋部以下创伤患者术前下肢深静脉血栓形成的影响因素分析

发布时间：2019-06-29 16:45

【摘要】：目的分析髋部以下创伤患者术前下肢深静脉血栓形成(DVT)的影响因素。方法选择359例髋部以下创伤患者,均拟行手术治疗。术前1天行下肢静脉顺行造影,记录患者下肢DVT发生情况。比较发生与未发生下肢DVT患者的临床资料及实验室检查结果[患者入院次日及术前1天血浆D-二聚体(D-dimer)、纤维蛋白原(FIB)、纤维蛋白原降解产物(FDP)水平],采用多因素Logistic回归法分析发生DVT的危险因素。结果 359例患者中,术前发生下肢DVT 50例、未发生下肢DVT 309例。发生与未发生下肢DVT患者的性别、年龄、BMI、烟酒不良嗜好、受伤至手术时间、基础疾病、入院次日及术前1天血浆FIB水平比较差异均无统计学意义(P均0.05),二者致伤原因、创伤部位、入院次日及术前1天血浆D-dimer水平、入院次日及术前1天血浆FDP水平比较差异均有统计学意义(P均0.05)。多因素Logistic回归分析结果显示,创伤部位、入院次日及术前1天血浆FDP水平是髋部以下创伤患者术前发生下肢DVT的独立影响因素(P均0.05)。结论创伤部位、入院次日及术前1天血浆FDP水平是髋部以下创伤患者术前发生下肢DVT的影响因素。
[Abstract]:Objective to analyze the influencing factors of (DVT) in patients with subhip trauma before operation. Methods 359 patients with subhip trauma were treated surgically. Anterograde venography of lower extremities was performed one day before operation to record the occurrence of DVT in lower extremities. The clinical data and laboratory results of patients with and without lower extremity DVT were compared, and the risk factors of DVT were analyzed by multivariate Logistic regression. The plasma D-dimer (D-dimer) and the level of fibrin (FIB), fibrin degradation product (FDP) were analyzed on the second day of admission and one day before operation. Results among 359 patients, 50 patients had DVT of lower extremity before operation, and 309 patients had no DVT of lower extremity. There were no significant differences in sex, age, BMI, smoking and alcohol addiction, time from injury to operation, basic diseases, plasma FIB levels on the second day of admission and 1 day before operation between the patients with and without lower extremity FIB. The causes of injury, the location of trauma, the level of plasma D-dimer on the second day of admission and 1 day before operation were not significantly different between the two groups. There were significant differences in plasma FDP levels between the second day of admission and one day before operation. The results of multivariate Logistic regression analysis showed that the location of trauma, the level of plasma FDP on the second day of admission and 1 day before operation were independent factors affecting the occurrence of DVT in patients with subhip trauma before operation (all P 0.05). Conclusion the plasma FDP level on the second day of admission and 1 day before operation is the influencing factor of lower extremity DVT in patients with subhip trauma.
【作者单位】：福建医科大学附属闽东医院;北京大学第四临床医学院北京积水潭医院;
【基金】：北京市医院管理局重点医学专业发展计划创伤骨科项目(ZYLX201506)
【分类号】：R687.3

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