住院患者静脉血栓栓塞症危险因素的病例对照研究  

Risk factors of venous thromboembolism among inpatients：a case-control study

作　　者：刘成媛[1] 刘晓涵[1] 陈曦[1] 武文文[2] 卢根娣[1] 

机构地区：[1]第二军医大学附属长征医院护理教研室,上海200003 [2]第二军医大学附属长征医院心胸外科,上海200003

出　　处：《中华现代护理杂志》2016年第24期3434-3437,共4页Chinese Journal of Modern Nursing

基　　金：上海市卫计委课题（201440088）

摘　　要：目的：回顾性收集分析住院患者的临床资料，了解住院患者静脉血栓栓塞症发生现状并探讨其相关的危险因素。方法以2011年9月—2014年9月就诊于上海市某三级甲等医院的539例静脉血栓栓塞症（ VTE）患者为VTE组，选择同时期同医院539例非VTE患者作为对照组，收集其临床资料并进行回顾性分析。结果单因素分析显示，VTE患者与非VTE患者年龄比较差异有统计学意义（ t＝5.421，P〈0.05），两组在是否体质量指数（BMI）〉25 kg/m2、大手术、恶性肿瘤、血栓史、肺炎、中心静脉置管、卧床〉72 h、中风、制动、骨盆/下肢骨折、关节置换方面比较差异有统计学意义（χ2值分别为9.868，29.711，16.230，48.050，5.613，16.443，5.735，20.403，4.340，20.646，10.343；P〈0.05）。 Logistic回归分析显示，中风、关节置换、骨盆/下肢骨折、中心静脉置管、手术史、大手术、BMI〉25 kg/m2、恶性肿瘤、年龄是患者发生VTE的危险因素（OR值6.414-1.559，P〈0.05）。结论对于同时具有多种VTE危险因素的患者，应有针对性的实施VTE预防策略。Objective To investigated the current situation and to explore the risk factors of venous thromboembolism （ VTE） among inpatients according to the retrospective analysis. Methods 539 VTE patients who had treated in a grade III class A hospital in Shanghai during September 2011 to September 2014 were chosen as the case group. The control group included patients who had no VTE but treated in the same hospital during that time. The clinical data of the participants were collected and retrospectively analyzed.Results Univariate analysis demonstrated significant differences in age （ t=5.421, P〈0.05） , BMI〉25 kg/m2 , major surgery, malignancy, VTE history, pneumonia, central venous catheter, stay in bed〉72 h, stroke, immobilization, pelvis/lower extremity fractures, and joint arthroplasty between the two groups （χ2=9.868, 29.711, 16.230, 48.050,5. 613, 16.443, 5.735, 20.403, 4.340, 20.646, 10.343; P〈0.05）. Furthermore, the logistic regression analysis indicated that the risk factors of VTE were related to stroke[OR=6.414 （2.421,16.995）], joint arthroplasty [OR=5.718（1.268,25.777）], pelvic/lowers extremity fractures[OR=4.918 （2.074,11.659）], central venous catheters[OR=3.446 （1.671,7.107）], surgery history[OR=2.245 （1.338,3.767）], major surgery [ OR=2.189 （ 1. 553, 3. 085 ） ] , BMI〉25 kg/m2 [ OR=1. 913 （ 1. 450, 2. 523 ） ] , malignancy [ OR=1. 713 （1. 184,2.477）], and age[OR=1.559 （1.343,1.810）].Conclusions More specific preventive strategies should be focused on and implemented to VTE patients as they suffered from various risk factors at the same time.

关 键 词：静脉血栓栓塞症 危险因素 病例对照 回顾分析 

分 类 号：R473.5[医药卫生—护理学]