老年腹腔镜手术患者术后深静脉血栓形成发生情况及危险因素分析  

Analysis of the occurrence and risk factors of postoperative deep venous thrombosis in elderly patients undergoing laparoscopic surgery

作　　者：敖永琼[1] 袁春梅[1] 左琳[1] AO Yong-qiong;YUAN Chun-mei;ZUO Lin(Department of Geriatrics,Chengdu Fifth People's Hospital,Chengdu 611130,China)

机构地区：[1]成都市第五人民医院老年科

出　　处：《中国医学前沿杂志（电子版）》2019年第6期117-120,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的探讨老年腹腔镜手术患者术后深静脉血栓形成(deep venous thrombosis,DVT)发生情况并分析其危险因素。方法选取2016年2月至2018年2月本院收治的270例老年腹腔镜手术患者为研究对象,根据术后是否发生DVT将其分为DVT组和非DVT组,记录影响术后DVT发生的相关因素,采用Logistic多元回归分析筛选其危险因素。结果270例腹腔镜手术患者中有10例术后发生DVT,发生率为3.70%;Logistic多元回归分析显示,年龄≥70岁、手术时间>2h、下腹及盆腔手术、术中头高脚低位、术后卧床时间≥30h、术后1d、3d血浆D-二聚体水平≥0.5mg/L均是腹腔镜手术后患者发生DVT的独立危险因素(均P<0.05)。结论老年腹腔镜手术患者术后发生DVT与年龄、手术时间、手术部位、术中体位、术后卧床时间、术后血浆D-二聚体水平密切相关,临床上应予以重视并采取适当的预防措施。Objective To investigate the occurrence of postoperative deep venous thrombosis (DVT) in elderly patients undergoing laparoscopic surgery and to analyze the risk factors.Method 270 cases of elderly patients underwent laparoscopic surgery from February 2016 to February 2018 in our hospital were selected for the study,and they were divide into DVT group and non-DVT group according to whether DVT occurred.The factors affecting the occurrence of postoperative DVT were recorded,and the risk factors were screened by Logistic multiple regression analysis.Result DVT occurred in 10 of 270 patients underwent laparoscopic surgery, with an incidence of 3.70%.Logistic multivariate regression analysis showed that the age ≥ 70 years old,operative time > 2 h,lower abdomen and pelvic surgery,reverse trendelenburg position during operation,postoperative bed rest time ≥ 30 h,plasma D-dimer level at one and three days after operation ≥ 0.5 mg/L were independent risk factors for DVT occurrence after laparoscopic surgery (all P < 0.05).Conclusion Postoperative DVT in elderly patients undergoing laparoscopic surgery is closely related to age,operation time,operation site,intraoperative position,postoperative bed rest time and postoperative plasma D-dimer level,so it should be paid attention to and appropriate preventive measures should be taken.

关 键 词：老年 腹腔镜手术 深静脉血栓形成 危险因素 D-二聚体 

分 类 号：R619[医药卫生—外科学]