创伤性骨折围手术期下肢深静脉血栓形成的危险因素分析  

Risk factors of lower extremity deep venous thrombosis during perioperative period of traumatic fracture

作　　者：陈晓燕[1] CHEN Xiao-yan(Department of Orthopaedics,Nanyang Central Hospital of Henan Province,Nanyang 473000,Henan,China)

机构地区：[1]河南省南阳市中心医院骨一科,河南南阳473000

出　　处：《中国校医》2021年第2期123-126,共4页Chinese Journal of School Doctor

摘　　要：目的探究下肢创伤性骨损伤患者在围手术期下肢深静脉血栓形成(DVT)的危险因素及常见指标对深静脉血栓形成的预测价值分析,以期为临床中及时检测及预防DVT提供参照。方法选取某医院2016年07月—2019年07月收治的因外伤性股损伤患者为研究对象,纳入的157名患者均接受手术治疗,根据围手术期是否发生DVT将患者分为观察组和对照组。通过单因素分析其手术前后可能存在的危险因素,进行单因素、多因素分析。结果两组患者在性别、术前平均体质指数(BMI)对比差异具有统计学意义(P<0.05)。两组患者术后D-2聚体、术后纤维蛋白原、术后血小板计数和切口感染具有差异(P值均<0.05)。经Logistic回归模型进行多因素分析提示:术前BMI、术后D-2聚体和切口感染是影响创伤性骨折术后DVT形成的独立危险因素,具有统计学意义(P<0.05)。进一步将指标纳入ROC分析,评价指标对测DVT发生的诊断价值,提示以0.650 pg/L为截点值,术后D-2聚体预测创伤骨折术后DVT发生的敏感度为86.62%,特异度为84.21%,曲线下面积为0.898,优于术前BMI指标。结论术前BMI、术后D-2聚体和切口感染是影响创伤性骨折术后DVT形成的独立危险因素,且术后D-2聚体对创伤性骨折术后DVT形成具有高效的预测作用。Objective To investigate the risk factors of perioperative deep venous thrombosis(DVT)in patients with lower extremity traumatic bone injury and the predictive value of common indicators for deep vein thrombosis in order to provide clinical reference for timely detection and prevention of DVT.Methods The clinical data of patients with traumatic femoral injuries admitted to a hospital were selected from July 2016 to July 2019.All the patients were treated with surgery in the hospital.According to whether DVT occurred during the perioperative period,the patients were divided into an observational group and a control group.The patients in the observation group had DVT,but the patients in the control group had not.The possible risk factors were analyzed by the univariate and multivariate analyses before and after the surgery.Results There were statistically significant differences between two groups in the gender and preoperative mean body mass index(BMI)(P<0.05).There were significant differences between two groups in the postoperative D-dimer,postoperative fibrinogen,postoperative platelet count,and wound infection(P<0.05).The multivariate analysis by logistic regression model showed that the preoperative BMI,postoperative D-dimer,and incision infection were the independent risk factors for DVT formation after traumatic fracture,which were statistically significant(P<0.05).Further,the index was included in the diagnostic value of the index in the receiver operating characteristic(ROC)curve to measure the occurrence of DVT,suggesting that the cut-off value of 0.650 pg/L was used.The sensitivity of postoperative D-dimer to predict DVT after traumatic fracture was 86.62%.At 84.21% of specificity,the area under the curve was 0.898,which was better than the preoperative BMI index.Conclusion Preoperative BMI,postoperative D-dimer,and incision infection are the independent risk factors for DVT formation after traumatic fracture,and the postoperative D-dimer has an efficient predictive effect on DVT formation after traumat

关 键 词：创伤性骨折 下肢深静脉血栓形成 下肢深静脉 围手术期 多因素分析 

分 类 号：R446.1[医药卫生—诊断学]