住院期间急性脑梗死合并孤立性远端深静脉血栓的转归及影响因素  

Outcome and influence factors of acute cerebral infarction combined with isolated distal deep vein thrombosis during hospitalization

作　　者：陈志强[1] 林春明 黄新 吴权辉[1] 庄佩佩 郭进明 李孝虎[1] 王耿[1] CHEN Zhi-qiang;LIN Chun-ming;HUANG Xin;WU Quan-hui;ZHUANG Pei-pei;GUO Jin-ming;LI Xiao-hu;WANG Geng(Department of Vascular Intervention,Traditional Chinese Medical Hospital of Zhongshan City,Zhongshan,Guangdong 528400,China)

机构地区：[1]中山市中医院血管介入科,广东中山528400

出　　处：《岭南现代临床外科》2022年第6期565-569,577,共6页Lingnan Modern Clinics in Surgery

摘　　要：目的 探讨住院期间急性脑梗死合并孤立性远端深静脉血栓(IDDVT)进展为肺栓塞的危险因素。方法 选取2019年1月至2021年12月在中山市中医院康复科收治的急性脑梗死合并IDDVT患者,收集病例资料和结局信息,分析IDDVT进展为肺栓塞的危险因素。结果 最终纳入研究对象141例,住院天数6~64(21.9±10.1)d,2例(1.4%)转归为近端深静脉血栓(PDVT),共13例(9.2%)发生肺栓塞,其中1例为高危型肺栓塞,12例为低危型肺栓塞。经单因素筛选及多因素logistic回归分析显示住院天数(OR=1.036,95%CI:1.034~1.164,P=0.002)、血栓累及双侧下肢(OR=6.163,95%CI:1.269~29.931,P=0.024)、D-二聚体升高(OR=1.122,95%CI:1.020~1.233,P=0.017)是急性脑梗死合并IDDVT转归为肺栓塞的独立危险因素。结论 住院期间急性脑梗死合并IDDVT转归为PDVT发生率较低,转归为肺栓塞发生率高,且可能造成高危型肺栓塞。住院天数、血栓累及双侧下肢、D-二聚体升高是急性脑梗死合并IDDVT转归为肺栓塞的独立危险因素。ObjectiveTo explore the risk factors for the progression of acute cerebral infarction combined with isolated distal deep vein thrombosis(IDDVT)to pulmonary embolism during hospitalization MethodsPatients with acute cerebral infarction combined with IDDVT who were admitted to the Traditional Chinese Medical Hospital of Zhongshan from January 2019 to December 2021 were enrolled. The case data and outcome information were collected,and the risk factors for the progression of IDDVT to pulmonary embolism were analyzed.ResultsA total of 141 patients were included in the study. The length of hospital stay was 6-64(21.9±10.1)days,2 patients(1.4%)developed into proximal deep vein thrombosis(PDVT). Thirteen patients(9.2%)developed into pulmonary embolism,of which 1 case was high-risk pulmonary embolism,and 12 were low-risk pulmonary embolism. Univariate analysis and multivariate logistic regression analysis showed that the length of hospital stay(OR=1.036,95%CI:1.034~1.164,P=0.002),thrombosis involving bilateral lower extremities(OR=6.163,95%CI:1.269~29.931,P=0.024),increased D-dimer(OR=1.122,95%CI:1.020-1.233,P=0.017)were independent risk factors of acute cerebral infarction combined with IDDVT developing into pulmonary embolism.Conclusion The incidence of acute cerebral infarction combined with IDDVT developing into PDVT during hospitalization is low,and the incidence of developing into pulmonary embolism is high,which may lead to highrisk pulmonary embolism. Length of hospital stay,thrombosis involving bilateral lower extremities,and increased D-dimer are independent risk factors of acute cerebral infarction combined with IDDVT developing into pulmonary embolism.

关 键 词：脑梗死 孤立性远端深静脉血栓 肺栓塞 影响因素分析 

分 类 号：R654.4[医药卫生—外科学] R743[医药卫生—临床医学]