脊柱骨折手术病人术后深静脉血栓形成危险因素及防控护理分析  

Analysis of risk factors and prevention and control nursing of postoperative deep vein thrombosis in patients undergoing spinal fracture surgery

作　　者：何杏贤[1] 卢向莉[1] 谢水群[1] 谭爱欢[1] 冯秀萍 HE Xingxian;LU Xiangli;XIE Shuiqun;TAN Aihuan;FENG Xiuping(The First People′s Hospital of Zhaoqing,Guangdong 526021 China)

机构地区：[1]肇庆市第一人民医院,526021

出　　处：《全科护理》2021年第16期2167-2170,共4页Chinese General Practice Nursing

摘　　要：目的:调查分析脊柱骨折手术病人术后深静脉血栓(DVT)形成的危险因素,并探究其防护对策。方法:对骨科收治的200例脊柱骨折手术病人进行回顾性分析,调查病人临床资料,统计术后深静脉血栓的发生率,运用单因素分析和多因素Logistic回归分析对脊柱骨折手术病人术后深静脉血栓形成危险因素进行分析,并制定相应的防控护理对策。结果:200例脊柱骨折中有11例病人术后发生DVT,发生率为5.50%。单因素分析显示,病人性别与术后发生DVT无明显相关,而病人年龄、体质指数(BMI)、糖尿病史、高血压史、高血脂、吸烟史、静脉曲张史、术后感染情况、术后卧床时间、术后抗凝药物使用情况与脊柱骨折术后发生DVT有明显相关(P<0.05);多因素Logistic回归分析结果显示,年龄>65岁、BMI>25 kg/m~2、合并糖尿病、高血压、高血脂和静脉曲张史,术后卧床时间>5 d均是脊柱骨折手术病人术后发生DVT的独立危险因素,而术后使用抗凝药物则是脊柱骨折手术病人术后DVT的独立性保护因素。结论:高龄、BMI高、合并糖尿病、高血压、高血脂等内科疾病、合并静脉曲张、术后长期卧床等均是脊柱骨折病人术后DVT形成的高危因素,为高危病人有效使用抗凝药物、加强DVT的评估、预防和护理是防止病人术后DVT发生的关键。Objective:To investigate and analyze the risk factors of postoperative deep vein thrombosis(DVT)in patients undergoing spinal fracture surgery and to explore its protective countermeasures.Methods:A retrospective analysis of 200 patients undergoing surgery for spinal fractures in the Department of Orthopedics of our hospital was carried out,with investigating the clinical data of the patients,counting the incidence of postoperative DVT,using univariate analysis and multivariate logistic regression analysis to analyze the risk factors of postoperative DVT,and formulating corresponding prevention and control nursing strategies.Results:Among the 200 cases of spinal fractures,11 patients had postoperative DVT,the incidence rate was 5.50%.According to univariate analysis,there was no significant correlation between the patient′s gender and postoperative DVT.In contrast,the patient′s age,body mass index(BMI),diabetes history,history of hypertension,hyperlipidemia,history of smoking,history of varicose veins,postoperative infection,postoperative bedtime,postoperative anticoagulant use were significantly related to the occurrence of DVT after spinal fracture(P<0.05);multivariate logistic regression analysis showed that age>65 years old,BMI>25 kg/m 2,history of diabetes,hypertension,hyperlipidemia,and varicose veins,and postoperative bed time>5 days were all independent risk factors of the occurrence of DVT in patients undergoing spinal fracture surgery.Postoperative use of anticoagulant drugs was an independent protective factor for postoperative DVT in patients with spinal fracture surgery.Conclusions:Old age,high BMI,medical diseases such as diabetes,hypertension,hyperlipidemia,varicose veins,and long-term bed rest after surgery were all high-risk factors for postoperative DVT in patients with spinal fractures.Therefore,it is practical to prevent DVT occurrence after surgery by using anticoagulant drugs for high-risk patients and enhancing the assessment,prevention,and nursing of DVT.

关 键 词：脊柱骨折 深静脉血栓 危险因素 防控护理 

分 类 号：R473.6[医药卫生—护理学]