ICU深静脉血栓形成高危患者DVT发生的危险因素分析  

Analysis of risk factors for DVT in ICU patients with high risk of deep vein thrombosis

作　　者：王自军 朱丽丽 孟盈 王飞 李华 游达礼 胡善友 王伟[4] 孙岚 WANG Zijun;ZHU Lili;MENG Ying;WANG Fei;LI Hua;YOU Dali;HU Shanyou;WANG Wei;SUN Lan(Department of ICU,Jiading District Central Hospital,Shanghai Medical College,Shanghai,201800,China;Department of Ultrasound Imaging,Jiading District Central Hospital,Shang hai Medical College;Department of Emergency,Jiading District Central Hospital,Shanghai Medical College;Department of Medical Imaging,Tongji Hospital,Shanghai)

机构地区：[1]上海健康医学院附属嘉定区中心医院重症监护室,上海201800 [2]上海健康医学院附属嘉定区中心医院超声影像科 [3]上海健康医学院附属嘉定区中心医院急诊科 [4]上海市同济医院医学影像科

出　　处：《临床急诊杂志》2020年第5期397-401,共5页Journal of Clinical Emergency

基　　金：上海市嘉定区卫计委科研项目基金(No:2017-KY-10);上海市科委“科技创新行动计划”项目(No:17411952300)。

摘　　要：目的:了解ICU危重症患者的DVT发生情况及探讨其发生的危险因素。方法:连续性收集我院2018-07—2019-06期间入住ICU的危重症患者,以Caprini量表为依据,将患者分为高危组(Caprini评分≥10分,n=100)和低危组(Caprini评分<10分,n=89),比较两组患者的一般临床资料及DVT发生的差异,采用多因素Logistic回归找出DVT发生高危患者的危险因素。结果:ICU危重症患者DVT的发生率为5.3%;相对于低危组,高危组患者的年龄、合并脑卒中、脓毒症、深静脉穿刺置管比例均显著增高(P均<0.05),同时,左足背动脉血流流速显著减慢[41.8(30.3,48.5)vs.47(35,57.2),P<0.01];多因素Logistic回归分析发现,左足背动脉流速减慢(OR=1.026,95%CI1.003~1.049,P=0.025)、合并脑卒中(OR=9.398,95%CI1.142~77.322,P=0.037)、深静脉置管(OR=2.451,95%CI1.022~5.876,P=0.044)是高危患者DVT发生的独立危险因素。结论:在ICU的危重症患者中,高危DVT患者的占比较高,合并脑卒中、行深静脉置管及左足背动脉流速减慢增加患者DVT的发生风险。Objective:To investigate the incidence of DVT in critically ill patients in ICU and explore the risk factors for DVT in these patients.Method:Clinical data were collected continuously from critically ill patients admitted to the ICU of our hospital from July 2018 to June 2019.Based on the Caprini scale score,patients were assigned to the high-risk group(Caprini score≥10 points,n=100)or low-risk Group(Caprini score<10 points,n=89)to compare the general clinical data and DVT incidence between the two groups.Multivariate Logistic regression analysis was performed to identify the risk factors for high-risk patients with DVT.Result:The incidence of DVT in critically ill patients in ICU was 5.3%.Compared with the low-risk group,age and incidences of complicating stroke,sepsis and deep vein catheterization were significantly increased in the high-risk group(P<0.05).Blood flow velocity in left dorsal pedal artery was significantly decreased in the high-risk group[41.8(30.3,48.5)vs.47(35,57.2),P<0.01].Multivariate Logistic regression analysis showed that decreased flow velocity in left dorsal pedal artery(OR=1.026,95%CI:1.003-1.049,P=0.025),stroke(OR=9.398,95%CI:1.142-77.322,P=0.037)and deep vein catheterization(OR=2.451,95%CI:1.022-5.876,P=0.044)were independent risk factors for DVT in high-risk patients.Conclusion:High-risk DVT patients account for a high proportion of critically ill patients in ICU.Decreased flow velocity in left dorsal pedal artery,stroke and deep vein catheterization increased the risk of DVT.

关 键 词：深静脉血栓 高危 危险因素 重症监护 危重症 

分 类 号：R543.6[医药卫生—心血管疾病]