颈髓损伤患者术后下肢深静脉血栓形成的影响因素分析  

Influential factors of deep venous thrombosis in patients with cervical spinal cord injury after surgery

作　　者：杨荣丽[1] 张伟[2] 万广[1] Yang Rongli;Zhang Wei;Wan Guang(Department of Orthopedics,the First Affiliated Hospital of Xinxiang Medical College,Xinxiang 453000,China;Department of Educational Affairs,the First Affiliated Hospital of Xinxiang Medical College,Xinxiang 453000,China)

机构地区：[1]新乡医学院第一附属医院骨外科,453000 [2]新乡医学院第一附属医院教务科,453000

出　　处：《中国实用医刊》2021年第2期24-27,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨颈髓损伤患者术后下肢深静脉血栓形成的影响因素。方法抽取2017年8月至2019年12月新乡医学院第一附属医院收治的颈髓损伤手术患者105例,按照术后是否形成下肢深静脉血栓将其分成对照组(81例)和病例组(24例)。统计患者性别、年龄、体质指数(BMI)、吸烟、基础疾病、大血管粥样硬化斑块、美国脊髓损伤学会脊髓损伤分级(ASIA分级)、激素、血红蛋白、红细胞比容。采用B超进行大血管粥样硬化斑块检查,确定是否有大血管粥样硬化斑块形成及部位。脊髓损伤ASIA分级参考ASIA评价标准。术前抽取患者肘静脉血3 ml,离心处理后留下血清,采用全自动生化分析仪检测血红蛋白、红细胞比容。结果单因素分析发现,年龄、BMI、吸烟、合并基础疾病、大血管粥样硬化斑块、美国脊髓损伤学会(ASIA)脊髓损伤分级、血红蛋白、红细胞比容是颈髓损伤患者术后下肢深静脉血栓形成影响因素单因素(P<0.05),是否使用激素不影响颈髓损伤患者术后下肢深静脉血栓形成(P>0.05)。多因素结果显示,合并高血压、糖尿病、冠心病、脊髓损伤(ASIA分级)A或B级、大血管粥样硬化斑块、血红蛋白、红细胞比容是颈髓损伤患者术后下肢深静脉血栓形成的独立危险因素。结论颈髓损伤患者术后下肢深静脉血栓形成影响因素较多,其中合并高血压、糖尿病、冠心病、脊髓损伤(ASIA)A或B级、大血管粥样硬化斑块、血红蛋白、红细胞比容是颈髓损伤患者术后下肢深静脉血栓形成独立危险因素。Objective To investigate the influential factors of deep venous thrombosis in patients with cervical spinal cord injury after surgery.Methods A total of 105 patients with cervical spinal cord injury in the First Affiliated Hospital of Xinxiang Medical College from August 2017 to December 2019 were enrolled,and they were divided into control group(n=81)and case group(n=24)according to the absence or presence of deep venous thrombosis.Data including age,gender,body mass index(BMI),smoking history,basic diseases,macrovascular atherosclerotic plaque,American Spinal Injury Association(ASIA)classification,hormones,hemoglobin,and hematocrit were recorded.Ultrasound was used to determine the presence and location of atherosclerotic plaques.Before operation,3 ml blood was drawn from the elbow vein,and the serum was left after centrifugation.Hemoglobin and hematocrit were detected by automatic biochemical analyzer.Results Univariate analysis found that age,BMI,smoking,basic diseases,macrovascular atherosclerotic plaques,ASIA classification,hemoglobin,and hematocrit were the influencing factors for lower extremity deep vein thrombosis after cervical spinal cord injury(P<0.05).The application of hormones had no correlation with the lower extremity deep vein thrombosis(P>0.05).Multivariate analysis showed that the patients with hypertension,diabetes,coronary heart disease,ASIA of grade A or B,macrovascular atherosclerotic plaque,hemoglobin and hematocrit were independent risk factors of lower extremity deep vein thrombosis.Conclusions There are many factors affecting the formation of deep vein thrombosis in the lower extremities after surgery in patients with cervical myelin injury,among which combined hypertension,diabetes,coronary heart disease,spinal cord injury(ASIA classfication of grade)A or B,large vascular atherosclerosis plaques,hemoglobin,erythropoies ratio is an independent risk factor for the formation of deep vein thrombosis in the lower extremities after surgery in patients with cervical myelin injury.

关 键 词：颈髓 损伤 下肢 深静脉血栓 

分 类 号：R651.2[医药卫生—外科学]