心胸外科患者术后下肢深静脉血栓形成的危险因素分析  

Analysis of risk factors of postoperative lower extremity deep venous thrombosis in patients undergoing cardiothoracic surgery

作　　者：王建红 楼新江 WANG Jianhong;LOU Xinjiang(Department of Cardiothoracic Surgery,Zhuji People′s Hospital in Zhejiang Province,Zhuji311800,China)

机构地区：[1]浙江省诸暨市人民医院心胸外科,浙江诸暨311800

出　　处：《中国现代医生》2022年第15期37-39,43,共4页China Modern Doctor

基　　金：浙江省中医药科技计划项目(2021ZA139)。

摘　　要：目的 探讨心胸外科患者术后下肢深静脉血栓形成(LEDVT)的相关危险因素,并提出预防策略。方法 选取2019—2020年浙江省诸暨市人民医院心胸外科术后发生LEDVT患者118例作为LEDVT组,同期随机选取未发生LEDVT的心胸外科患者236例为非LEDVT组,对所有患者进行调查;比较两组间的性别、年龄、体质量指数、吸烟史、饮酒史、高血压、心血管疾病、脑血管疾病、糖尿病、动脉粥样硬化、静脉血栓史、术前D-二聚体、术前血小板计数、手术时间、术中输血、预防性使用抗凝药物、术后活动时间、卧床时间等;采用逐步logistic回归法筛选影响心胸外科患者术后发生LEDVT的相关危险因素。结果 多因素分析结果显示,影响心胸外科患者术后发生LEDVT的危险因素包括高血压(OR=2.517)、动脉粥样硬化(OR=5.254)、静脉血栓史(OR=4.697)、术前D-二聚体(OR=5.540)、手术时间(>2 h)(OR=2.846)及卧床时间(≥3 d)(OR=3.059),而预防性使用抗凝药物(OR=0.401)则为保护因素。结论 应针对这些高危因素,做到早筛查、早预防、早诊断及早治疗LEDVT,降低LEDVT发生率。Objective To investigate the risk factors of postoperative lower extremity deep venous thrombosis LEDVT in patients undergoing cardiothoracic surgery and propose preventive strategies. Methods From 2019 to 2020, a total of118 patients with LEDVT after cardiothoracic surgery in Zhuji People′s Hospital in Zhejiang Province were selected as LEDVT group, and 236 patients without LEDVT after cardiothoracic surgery were randomly selected as non-LEDVT group during the same period. All patients were investigated. Sex, age, body mass index, smoking history, drinking history, hypertension, cardiovascular disease, cerebrovascular disease, diabetes, atherosclerosis, venous thrombosis history, preoperative D-dimer, preoperative platelet count, operation time, intraoperative blood transfusion, prophylactic use of anticoagulant drugs, postoperative activity time, and bed rest time were compared between the two groups. The stepwise logistic regression method was used to screen the risk factors affecting LEDVT after cardiothoracic surgery.Results The multivariate analysis results showed that the risk factors affecting postoperative LEDVT in cardiothoracic surgery patients included hypertension(OR=2.517), atherosclerosis(OR=5.254), history of venous thrombosis(OR=4.697), preoperative D-dimer(OR=5.540), operation time(>2 h)(OR=2.846) and bed rest time(≥3 d)(OR=3.059),while prophylactic use of anticoagulant drugs(OR=0.401) was a protective factor. Conclusion For these risk factors,early screening, early prevention, early diagnosis, and early treatment of LEDVT should be done to reduce the incidence of LEDVT.

关 键 词：心胸外科 下肢深静脉血栓 血栓 危险因素 

分 类 号：R619.2[医药卫生—外科学]