腰椎融合术后下肢深静脉血栓形成的危险因素分析  

RISK FACTORS FOR LOWER EXTREMITY DEEP VEIN THROMBOSIS AFTER LUMBAR FUSION SURGERY

作　　者：邵成 西永明[1] SHAO Cheng;XI Yongming(Department of Spinal Surgery,The Affiliated Hospital of Qingdao University,Qingdao 266100,China)

机构地区：[1]青岛大学附属医院脊柱外科,山东青岛266100

出　　处：《精准医学杂志》2022年第4期355-359,共5页Journal of Precision Medicine

基　　金：山东省自然科学基金资助项目(ZR2019MH11)。

摘　　要：目的探讨腰椎融合术后下肢深静脉血栓形成(deep vein thrombosis,DVT)的危险因素。方法回顾性分析2019年1月—2020年12月于青岛大学附属医院脊柱外科接受腰椎融合术治疗的360例患者的临床资料,根据术后7 d内有无下肢DVT发生分为血栓组(39例)和非血栓组(321例)。采用单因素分析和二元Logistic回归分析筛选腰椎融合术后下肢DVT的危险因素。结果单因素分析结果显示,年龄、高血压史、糖尿病病史、脑梗死病史、手术时长、术中出血量和术后血清中D-二聚体水平与腰椎融合术后下肢DVT有关(t/χ^(2)=5.482~53.329,P<0.05);多因素Logistic回归分析显示,高血压史(OR=12.821,95%CI=4.403~37.366,P<0.05)、脑梗死病史(OR=11.366,95%CI=1.902~67.920,P<0.05)、手术时长延长(OR=1.020,95%CI=1.011~1.028,P<0.05)和术后血清中D-二聚体水平升高(OR=21.543,95%CI=7.188~64.569,P<0.05)是腰椎融合术后患者下肢DVT发生的危险因素。结论高血压史、脑梗死病史、手术时长延长和术后血清中D-二聚体水平升高是腰椎融合术后患者下肢DVT发生的危险因素,对具有上述危险因素的患者,应警惕术后DVT的发生,并采取及时有效的预防措施。Objective To investigate the risk factors for lower extremity deep vein thrombosis(DVT)after lumbar fusion surgery.Methods A retrospective analysis was performed for the clinical data of 360 patients who underwent lumbar fusion surgery in Department of Spinal Surgery,The Affiliated Hospital of Qingdao University,from January 2019 to December 2020,and according to the presence or absence of lower extremity DVT within 7 d after surgery,they were divided into DVT group with 39 patients and non-DVT group with 321 patients.A univariate analysis and a binary Logistic regression analysis were used to screen out the risk factors for lower extremity DVT after lumbar fusion.Results The univariate analysis showed that age,history of hypertension,history of diabetes,history of cerebral infarction,time of operation,intraoperative blood loss,and postope-rative serum D-dimer level were associated with lower extremity DVT after lumbar fusion(t/χ^(2)=5.482-53.329,P<0.05).The multivariate Logistic regression analysis showed that history of hypertension(OR=12.821,95%CI=4.403-37.366,P<0.05),history of cerebral infarction(OR=11.366,95%CI=1.902-67.920,P<0.05),prolonged time of operation(OR=1.020,95%CI=1.011-1.028,P<0.05),and elevated postoperative serum D-dimer level(OR=21.543,95%CI=7.188-64.569,P<0.05)were risk factors for lower extremity DVT after lumbar fusion.Conclusion History of hypertension,history of cerebral infarction,prolonged time of operation,and elevated postoperative serum D-dimer level are risk factors for lower extremity DVT after lumbar fusion,and for patients with the above risk factors,postoperative lower extremity DVT should be monitored to take timely and effective preventive measures.

关 键 词：脊柱融合术 腰椎 静脉血栓形成 下肢 危险因素 因素分析 统计学 

分 类 号：R543[医药卫生—心血管疾病]