骨科患者深静脉血栓形成的影响因素分析  

Analysis effect factors of orthopedic deep venous thrombosis

作　　者：罗德军[1] 周贵[2] 李水燕 张兆尧[1] 何发友 朱庆茂 杨博[1] LUO Dejun;ZHOU Gui;LI Shuiyan;ZHANG Zhaoyao;HE Fayou;ZHU Qingmao;YANG Bo(Department of Orthopaedics,People's Hospital of Jianyang City,Chengdu,Sichuan 641400,China;Department of Hospital Infection-Control,Fifth People's Hospital of Chengdu,Chengdu,Sichuan 610000,China)

机构地区：[1]四川省成都市简阳市人民医院骨科,四川成都641400 [2]四川省成都市第五人民医院院感科,四川成都610000

出　　处：《检验医学与临床》2020年第9期1221-1224,1228,共5页Laboratory Medicine and Clinic

基　　金：四川省医学会资助项目(S17036)。

摘　　要：目的探讨骨科患者入院时血常规、血生化、血糖、血脂、红细胞沉降率、凝血指标、C反应蛋白、血栓弹力图等指标,以及采用低分子肝素抗凝是否为深静脉血栓形成(DVT)的影响因素。方法选择2018年1-12月简阳市人民医院1 341例骨科住院患者为研究对象。按超声筛查结果,判断是否存在DVT,采用单因素和多因素Logistic回归分析血常规、血生化、血糖、血脂、红细胞沉降率、凝血指标、C反应蛋白、血栓弹力图,是否采用预防性抗凝等与DVT的关系。结果不同性别(χ2=4.424,P=0.035)、主要诊断(χ2=82.669,P<0.001)、受伤原因(χ2=27.490,P<0.001)、血栓弹力图(χ2=40.749,P<0.001)的患者发生DVT的风险不同。采用低分子肝素进行预防性抗凝的患者发生DVT的风险低于未采用低分子肝素预防性抗凝的患者(χ2=117.547,P<0.001)。Logistic回归分析显示,主要诊断、受伤原因、血糖、血脂、C反应蛋白、纤维蛋白原降解产物(FDP)、采用低分子肝素抗凝是DVT发生的危险因素(P<0.05)。结论骨科患者入院时血糖、血脂、C反应蛋白、FDP等是DVT的危险因素,可作为患者DVT的预测指标,采用低分子肝素对骨科患者进行预防性抗凝对DVT具有较好的预防效果。Objective To explore whether blood routine,blood biochemistry,blood glucose,blood lipid,erythrocyte sedimentation,coagulation indicators,C-reactive protein,thromboelastography is the effect factors of deep venous thrombosis(DVT)in orthopaedic patients at admission.Methods A total of 1 341 orthopaedic inpatients from January 2018 to December 2018 in People′s Hospital of Jianyang City were selected as objects in this study.The relationship between blood routine,blood biochemistry,blood glucose,blood lipid,erythrocyte sedimentation,coagulation indictors,C-reactive protein,thromboelastography,prophylactic anticoagulation and DVT were analyzed by single factor and multifactor Logistic regression.Results Patients with different different gender(χ~2=4.424,P=0.035),main diagnosis(χ~2=82.669,P<0.001),cause of injury (χ~2=27.490,P<0.001),thromboelastography(χ~2=40.749,P<0.001)had different risk of DVT.The risk of DVT was lower in patients using low-molecular-weight heparin for preventive anticoagulation (χ~2=117.547,P<0.001).Logistic regression analysis showed that the main risk factors for DVT were diagnosis disease,injury cause,blood sugar,blood lipid,C-reactive protein,fibrinogen degradation products(FDP),low molecular weight heparin and so on(P<0.05).Conclusion Blood glucose,blood lipid,C-reactive protein and FDP are risk factors of DVT in orthopaedic patients at admission,which can be used as predictors of thrombosis.Early intervention using low-molecular-weight heparin for orthopaedic patients is needed.

关 键 词：凝血指标 低分子肝素 血脂 C反应蛋白 静脉血栓 

分 类 号：R683[医药卫生—骨科学]