创伤性下肢胫腓骨骨折合并肌间血栓的危险因素研究及护理对策  

Risk Factors and Nursing Strategies for Traumatic Lower Extremity Tibia and Fibula FracturesComplicated with Intermuscular Thrombosis

作　　者：邹镜宜[1] 何惠兰[1] 区海云[1] ZOU Jing-yi;HE Hui-an;OU Hai-yun(Department of orthopedics,Zhaoqing first People's hospital,Zhaoqing,Guangdong,526000)

机构地区：[1]肇庆市第一人民医院骨科,广东肇庆526000

出　　处：《中国伤残医学》2022年第23期35-39,53,共6页Chinese Journal of Trauma and Disability Medicine

摘　　要：探讨创伤性下肢胫腓骨骨折合并肌间血栓的危险因素,并制定护理对策。方法:回顾性分析我院2017年6月-2019年6月收治的创伤性下肢胫腓骨骨折患者225例的临床资料,采用Autar量表进行VTE风险评估或下肢静脉彩超检查将患者分为肌间血栓组和无肌间血栓组,比较2组患者性别、年龄、体质量、有无吸烟、有无喝酒、合并其他骨折、骨折部位、有无糖尿病、有无心脏病、有无高血压、卧床时间、手术时间以及有无锻炼等差异,并采用logistic回归分析筛选其独立危险因素。结果:根据肌间血栓组与无肌间血栓组一般临床资料对比结果,剔除(P>0.05)的因素,对年龄、糖尿病、心脏病、长期卧床以及锻炼进行多因素Lo-gistic回归分析表明:年龄≥60岁(OR=2.365,95%CI:1.087-5.146)、糖尿病(OR=2.657,95%CI:1.231-5.735)、心脏病(OR=2.725,95%CI:1.250-5.942)、长期卧床(OR=2.401,95%CI:1.097-5.256)、没有锻炼(OR=0.220,95%CI:0.101-0.480)为创伤性下肢胫腓骨骨折合并肌间血栓的独立危险因素,具有统计学差异(P<0.05)。结论:创伤性下肢胫腓骨骨折患者发生肌间血栓概率较高,临床医生和护士应对其予以重视,结合危险因素制定相应的治疗方案和护理方法,降低肌间血栓形成的风险,提高术后治愈效果,在临床治疗中具有重要意义。To investigate the risk factors of traumatic lower extremity tibia and fibula fractures compli-cated with intermuscular thrombosis,and to formulate nursing countermeasures.Methods:The clinical data of 225 patients with traumatic lower extremity tibia and fibula fractures treated in our hospital from June 2017 to June 2019 were retrospectively analyzed.The Autar scale was used for VTE risk assessment or lower extremity venous ultra-sonography to classify the patients into intermuscular The thrombus group and the no intramuscular thrombus group were compared in terms of gender,age,weight,smoking,drinking,other fractures,fracture site,diabetes,heart disease,hypertension,time in bed,The operation time and the presence or absence of exercise were different,and the independent risk factors were screened by logistic regression analysis.Results:According to the comparison re-sults of general clinical data between the intramuscular thrombosis group and the non-intermuscular thrombosis group,the factors of age,diabetes,heart disease,long-term bed rest and exercise were excluded(P>0.05),and the multivariate Logistic regression analysis showed that age≥60 years old(OR=2.365,95%CI:1.087-5.146),diabetes(OR=2.657,95%CI:1.231-5.735),heart disease(OR=2.725,95%CI:1.250-5.942),long-term bed rest(OR=2.401,95%CI:1.097-5.256)and no exercise(OR=0.220,95%CI:0.101-0.480)were independent risk factors for traumatic lower extremity tibia and fibula fractures complicated with intermuscular thrombosis,with statistical difference(P<0.05).Conclusion:The incidence of intermuscular thrombosis in pa-tients with traumatic lower extremity tibia and fibula fractures is high.Clinicians and nurses should pay attention to it,and formulate corresponding treatment plans and nursing methods in combination with risk factors to reduce the risk of intermuscular thrombosis and improve postoperative healing effect.Which is of great significance in clinical treatment.

关 键 词：创伤性下肢胫腓骨骨折 肌间血栓 危险因素 护理对策 

分 类 号：R683.42[医药卫生—骨科学]