髋部骨折术前下肢深静脉血栓发生的危险因素分析  

Risk factors of lower extremity deep vein thrombosis before hip fracture preoperative

作　　者：吕春生[1] Lyv Chunsheng(Xiji People′s Hospital, Guyuan 756299, China)

机构地区：[1]西吉县人民医院,固原756299

出　　处：《中华关节外科杂志（电子版）》2021年第5期623-627,共5页Chinese Journal of Joint Surgery(Electronic Edition)

摘　　要：目的分析髋部骨折术前下肢深静脉血栓发生的危险因素。方法回顾性收集2018年1月至2021年4月西吉县人民医院收治的髋部骨折患者的临床资料,根据患者术前下肢深静脉血栓的发生情况将其分为发生组和未发生组。分析发生组和未发生组一般资料,通过多因素logistic回归分析法分析髋部骨折术前下肢深静脉血栓发生的危险因素。结果254例髋部骨折术前发生下肢深静脉血栓30例,术前下肢深静脉血栓发生率为11.81%。发生组患者活化部分凝血活酶时间短于未发生组(t=2.075,P<0.05),血红蛋白、白蛋白水平低于未发生组(t=7.787、2.279,P<0.05);发生组年龄≥70岁、受伤至手术时间≥5 d、骨折类型为股骨粗隆间骨折的患者占比分别为73.33%、93.33%、66.67%,均高于未发生组的49.11%、62.95%、45.54%(χ^(2)=6.221、10.972、4.733,均为P<0.05)。多因素logistic回归分析结果显示,年龄≥70岁、受伤至手术时间≥5 d、骨折类型为股骨粗隆间骨折、活化部分凝血活酶时间短是髋部骨折术前下肢深静脉血栓发生的独立危险因素[比值比(OR)=2.083、2.259、2.100、2.000,均为P<0.05]。结论髋部骨折术前下肢深静脉血栓发生率较高;其危险因素包括年龄≥70岁、受伤至手术时间≥5 d、骨折类型为股骨粗隆间骨折、活化部分凝血活酶时间短等。临床可据此对髋部骨折患者采用有针对性的治疗和护理,以降低髋部骨折术前发生下肢深静脉血栓的风险。Objective To analyze the risk factors of lower extremity deep vein thrombosis before hip fracture preoperative.Methods The clinical data of 254 patients with hip fracture admitted to Xiji People′s Hospital from January 2018 to April 2021 were retrospectively collected and divided into the occurrence group and the non-occurrence group according to the occurrence of lower extremity deep vein thrombosis before surgery.The general data of the occurrence group and the non-occurrence group were analyzed.The risk factors of lower extremity deep vein thrombosis before hip fracture preoperative were analyzed by multivariate logistic regression analysis method.Results A total of 254 patients with hip fracture were enrolled,among them,30 patients had lower extremity deep vein thrombosis before surgery,and the incidence of lower extremity deep vein thrombosis before surgery was 11.81%.The activated partial thrombin time in the occurrence group was shorter than that in the non-occurrence group(t=2.075,P<0.05),the levels of hemoglobin and albumin were lower than those in the non-occurrence group(t=7.787,2.279,both P<0.05).The proportion of patients aged≥70 years,time from injury to surgery≥5 d and fracture type of intertrochanteric fracture of femur in the occurrence group were 73.33%,93.33%and 66.67%,respectively,which were higher than 49.11%,62.95%and 45.54%in the non-occurrence group(χ^(2)=6.221,10.972,4.733,all P<0.05).Multivariate logistic regression analysis showed that age≥70 years,time from injury to surgery≥5 d,fracture type of intertrochanteric fracture of femur,and short activated partial thrombin time were independent risk factors for lower extremity deep vein thrombosis before hip fracture preoperative[odds ratio(OR)=2.083,2.259,2.100,2.000,all P<0.05].Conclusions The incidence of preoperative lower extremity deep vein thrombosis is higher in hip fracture,and the risk factors including age≥70 years,time from injury to surgery≥5 d,intertrochanteric fracture of femur,and short activated partial thromb

关 键 词：髋骨折 下肢 静脉血栓形成 手术前期 危险因素 

分 类 号：R68[医药卫生—骨科学]