脊椎融合术后下肢深静脉血栓形成的危险因素分析  

Risk factors of early deep venous thrombosis in lower extremity after spinal fusion surgery

作　　者：易伟林 梁斌[1] 丘德赞[1] 韦建勋[1] 陈峰[1] 楚野[1] 李东冉 黎帅宏 

机构地区：[1]广西壮族自治区人民医院骨科,南宁530021

出　　处：《中国矫形外科杂志》2018年第1期22-26,共5页Orthopedic Journal of China

摘　　要：[目的]探讨脊椎融合术后早期下肢深静脉血栓形成的危险因素。[方法]选取于2015年7月~2017年1月在广西壮族自治区人民医院骨科接受脊椎融合术治疗的患者共216例,依据术后超声检查结果双下肢有无血栓形成,分为DVT组和非DVT组。对比两组患者的年龄、性别、体重指数、糖尿病、高血压病、术前凝血四项、D-二聚体、融合节段数、手术时间、术中输血、术后使用抗凝药、术后卧床时间等指标,再采用Logistic多因素回归分析,探讨脊椎融合术后早期并发下肢DVT的危险因素。[结果]共纳入216例患者,其中男性87例,女性129例,术后并发下肢DVT 33例,占15.3%,其中有症状者3例,均为腰椎退变性疾病患者,占全部患者数的1.4%,非DVT组183例。单因素x^2检验显示两组在年龄、体重指数、手术时间、术中输血、术后卧床时间等指标差异具有统计学意义(P<0.05);上述因素经Logistic多因素回归分析显示:年龄≥60岁、体重指数≥24 kg/m^2、术中输血、术后卧床天数≥5 d是脊椎融合术后早期并发DVT的独立危险因素。[结论]年龄≥60岁、体重指数≥24 kg/m^2、术中输血、术后卧床天数≥5 d的患者脊椎融合术后早期更容易出现下肢DVT形成。[Objective] To explore the risk factors of early deep vein thrombosis in the lower extremity after spinal fusion surgery. [Method] A total of 216 patients who underwent spinal fusion surgery in the People＇s Hospital of Guangxi Zhuang Autonomous Region from July 2015 to January 2017 were enrolled into this study. According to results of ultrasonography on both low- er extremities after surgery, the patients were divided into two groups, the DVT group and the non DVT group. Age, gender, BMI, diabetes, hypertension, blood clotting function, D-dimer, fusion segments, operating time, blood transfusion, anticoagu- lants, postoperative bed time were recorded. Chi-square test and multivariate logistic regression were used to explore the risk factors of DVT. [Result] Of the 216 patients, including 87 males and 129 females, 33 patients （15.3%） developed DVT after sur- gery with 3 symptomatic patients （1.4%） and 30 asymptomatic patients were classified as the DVT group, whereas the remain- ing 183 patients without DVT were fallen into non DVT group. Cbi-square test showed there were significant differences be- tween the two groups in age, BMI, operation time, blood transfusion and postoperative bed time. In addition, multivariate logis- tic regression revealed age ≥60, BMI≥24 kg/m2, blood transfusion and postoperative bed time≥5 days were risk factors associ- ated with occurrence of DVT after spinal fusion surgery. [Conclusion] The patients with age t〉60, BMI≥24 kg/m2, blood trans- fusion and postoperative bed time≥5 days are more likely to have early deep vein thrombosis of lower extremity after spinal fuslon surgery

关 键 词：脊椎融合术 早期 下肢深静脉血栓 危险因素 

分 类 号：R687.3[医药卫生—骨科学] R681.5[医药卫生—外科学]