老年髋部骨折病人术前并发深静脉血栓危险因素的Meta分析  

Risk factors for preoperative deep vein thrombosis in elderly patients with hip fracture:a Meta-analysis

作　　者：梁臣 秦霞[2] 李爱仙[2] LIANG Chen;QIN Xia;LI Aixian(Medical College of Jiangsu University,Jiangsu 212013 China)

机构地区：[1]江苏大学医学院,江苏212013 [2]江苏大学附属昆山医院

出　　处：《循证护理》2022年第11期1429-1433,共5页Chinese Evidence-Based Nursing

基　　金：昆山市社会发展科技专项(指令性)项目,编号:KS1968。

摘　　要：目的:系统评价老年髋部骨折病人术前发生下肢深静脉血栓(DVT)的危险因素,为临床预防决策提供依据。方法:计算机检索中国知网(CNKI)、万方数据库(WanFang Database)、维普数据库(VIP)、中国生物医学文献数据库(CBM)、PubMed、Web of Science、the Cochrane Library,搜集建库至2021年6月1日有关老年髋部骨折病人术前发生下肢DVT危险因素的相关文献,由2名研究者独立筛选文献并进行质量评价。提取各危险因素的优势比(OR)、加权均方差(WMD)值及95%置信区间(CI),采用RevMan 5.3进行Meta分析。结果:共纳入11篇文献,结果显示年龄[WMD=3.75,95%CI(1.46,6.03),P=0.001]、受伤至入院时间[WMD=0.89,95%CI(0.65,1.14),P<0.00001]、股骨粗隆间骨折[OR=2.07,95%CI(1.57,2.73),P<0.00001]、高脂血症[OR=4.59,95%CI(2.41,8.77),P<0.00001]、骨折前长期卧床[OR=9.37,95%CI(2.78,31.58),P=0.0003]等为老年髋部骨折病人术前发生下肢DVT的危险因素。结论:现有证据表明,年龄、受伤至入院时间、受伤至检查时间、股骨粗隆间骨折、D-聚体、白蛋白、纤维蛋白原、缺血性脑血管疾病、高脂血症、静脉血栓栓塞症病史、骨折前长期卧床为老年髋部骨折病人术前发生下肢DVT的危险因素。但受纳入研究数量和质量影响,结论尚需开展更多高质量研究予以验证。Objective:To systematically evaluate the risk factors of preoperative deep vein thrombosis(DVT)of lower extremity in elderly patients with hip fracture,and to provide basis for clinical decision-making.Methods:Literature about risk factors of preoperative lower extremity DVT in elderly patients with hip fracture was retrieved from CNKI,WanFang Database,VIP,CBM,PubMed,Web of Science,the Cochrane Library.The retrieval time was from the establishment of each database to June 1,2021.Two investigators independently screened literature and conducted quality assessment.The odds ratio(OR)value,WMD and 95%confidence interval(CI)of each risk factor were extracted,and RevMan 5.3 was used for Meta-analysis.Results:A total of 11 papers were included.The results showed that age[WMD=3.75,95%CI(1.46,6.03),P=0.001],time from injury to admission[WMD=0.89,95%CI(0.65,1.14),P<0.00001],intertrochanteric femoral fracture[OR=2.07,95%CI(1.57,2.73),P<0.00001],hyperlipidemia[OR=4.59,95%CI(2.41,8.77),P<0.00001],long-term bed rest before fracture[OR=9.37,95%CI(2.78,31.58),P=0.0003]were the risk factors for preoperative DVT in elderly patients with hip fracture.Conclusions:Existing evidence indicates that age,time from injury to admission,time from injury to examination,intertrochanteric fracture of femur,D-aggregates,albumin,fibrinogen,ischemic cerebrovascular disease,hyperlipidemia,history of venous thromboembolism,and long-term bed rest before fracture are risk factors for preoperative DVT of lower extremity in elderly patients with hip fracture.However,due to the influence of the number and quality of the included studies,the conclusion needs to be verified by more high-quality studies.

关 键 词：髋部骨折 老年人 深静脉血栓 危险因素 META分析 循证护理 

分 类 号：R473.6[医药卫生—护理学]