脊柱外科病人围手术期血栓预防及相关因素分析  

Perioperative Thrombosis Prevention for Spine Surgery Patients and Correlative Factor Analysis

作　　者：张洪斌[1] 杨佐明[1] 李永民[1] 王旭[1] 曹恒聪[1] 谷守山[1] 原野[1] 

机构地区：[1]河北省唐山市第二医院脊柱外科,063000

出　　处：《中国骨与关节损伤杂志》2009年第8期695-697,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的探讨脊柱外科病人围手术期肺栓塞(PE)和下肢深静脉血栓(DVT)的预防方法。方法回顾性分析1330例行脊柱外科手术的病人,发生有症状PE 9例,DVT 32例。其中干预组760例,发生DVT 10例,PE 2例;对照组570例,发生DVT 22例,PE 7例,两组比较发生率;两组随机选取行脊柱外科4种手术者各50例,记录手术出血量和术后24 h伤口引流量,应用SPSS 10.0软件进行χ2和t检验。结果干预组DVT和PE发生率由3.86%和1.23%分别降至1.32%和0.26%,差别有显著性(DVTχ2=8.976,P=0.003;PEχ2=4.512,P=0.034)。手术出血量方面,两组差别无显著性(P>0.05);术后24 h伤口引流量方面,干预组大于对照组,差别有显著性(P<0.05)。两组并发上消化道出血各1例,差别无显著性(χ2=0.042,P=0.838)。结论对于脊柱外科病人,围手术期规范化血栓监测和预防性治疗是安全和必要的。Objective To explore the preventive ways of pulmonary embolism （PE） and deep vein thrombosis （DVT） of lower extremity for the spine surgery patients in the perioperative period. Methods The clinical data of 1330 patients were reviewed, in which 9 patients had symptomatic PE and 32 patients DVT. Among 760 patients in intervention group, 10 patients had DVT and 2 PE while among 570 patients in control group, 22 had DVT and 7 PE. The rate of PE and DVT were compared between the two groups. Fifty eases each of 4 kinds of operations in spine surgery were selected and divided it into two groups by random： intervention group and control group. The volume of bleeding during and post operations within 24 h and bleeding related complications was recorded. The data were analyzed with t-test and ehi-square test with SPSS 10.0. Results By the standardization thrombosis preventive measure, the DVT and PE rate in eontrol group were decreased from3.86% and 1.23% to 1.32% and 0.26% respectively. The difference was significant （DVT χ^2=8.976,P=0.003; PE χ^=4.512,P=0.034）. The volume of bleeding during operations has no notable difference in the two groups（P〉0.05）, but the volume of bleeding post-operations within 24 h in intervention group was higher than that in control group （P〈0.05）. There was one operation bleed- ing happening in each group, which had no significant difference （χ^2=0.042,P=0.838）. Conclusion For patients of spine surgery, standardization embolism inspection and prevention treatment is safe and necessary around operations.

关 键 词：肺栓塞 深静脉血栓形成 围手术期 并发症 

分 类 号：R681.5[医药卫生—骨科学] R473.6[医药卫生—外科学]