Ⅳ型孟氏骨折术后下肢深静脉血栓形成的危险因素分析  

Analysis of risk factors for lower extremity deep vein thrombosis after typeⅣMonteggia fracture surgery

作　　者：杨锦帆 周雄清 李永灵[1] YANG Jin-fan;ZHOU Xiong-qing;LI Yong-ling(Department of Orthopedics,Wuhua County People's Hospital,Meizhou 514400,China)

机构地区：[1]五华县人民医院骨科,514400

出　　处：《中国现代药物应用》2023年第8期9-13,共5页Chinese Journal of Modern Drug Application

基　　金：梅州市科技计划项目(项目编号:211208162050806)项目名称:Ⅳ型孟氏骨折术后下肢深静脉血栓形成的危险因素分析。

摘　　要：目的分析Ⅳ型孟氏骨折术后深静脉血栓形成(DVT)的相关危险因素。方法回归性分析228例Ⅳ型孟氏骨折患者的临床资料,以术后2周内复查血管B超是否发生DVT分为血栓组(35例)和非血栓组(193例)。比较两组患者临床资料,并进行Ⅳ型孟氏骨折术后发生DVT的多因素Logistic分析。结果两组患者性别、冠心病占比、脑梗死占比及术前血红蛋白、平均血小板体积(MPV)、谷丙转氨酶、谷草转氨酶及尿酸水平比较,差异均无统计学意义(P>0.05)。血栓组患者平均年龄为(46.70±8.10)岁,体质量指数(BMI)为(23.30±4.50)kg/m^(2),有吸烟饮酒史25例,有高血压15例及有糖尿病16例,手术时间为(114.52±30.89)min,术后使用抗凝药物5例,术中出血量为(122.85±18.74)ml,术后出血量为(139.56±21.09)ml,术前血小板计数(PLT)为(155.74±64.42)×10^(9)/L,术前肌酐为(72.80±28.55)μmol/L,术前血浆D-二聚体为(13.49±9.77)mg/L,术前凝血酶时间为(21.09±1.01)s,术前活化部分凝血活酶时间为(21.58±0.87)s。非血栓组患者平均年龄为(30.50±7.20)岁,BMI为(21.60±4.20)kg/m^(2),有吸烟饮酒史35例,有高血压31例及有糖尿病35例,手术时间为(104.68±26.42)min,术后使用抗凝药物120例,术中出血量为(61.18±12.69)ml,术后出血量为(64.25±15.56)ml,术前PLT为(183.19±70.99)×10^(9)/L,术前肌酐为(64.46±20.70)μmol/L,术前血浆D-二聚体为(9.60±10.79)mg/L,术前凝血酶时间为(29.56±2.12)s,术前活化部分凝血活酶时间为(33.64±1.02)s。血栓组患者年龄、吸烟饮酒史占比、糖尿病占比、高血压占比、术后使用抗凝药物占比、术中出血量、术后出血量均大于非血栓组,BMI及术前肌酐、血浆D-二聚体水平均高于非血栓组,手术时间长于非血栓组,术前PLT低于非血栓组,术前凝血酶时间和活化部分凝血活酶时间短于非血栓组,差异有统计学意义(P<0.05)。多因素Logistic分析得出,年龄大、有糖尿病、BMI高、有吸烟饮Objective To analyze the risk factors for lower extremity deep vein thrombosis(DVT)after typeⅣMonteggia fracture surgery.Methods The clinical data of 228 patients with typeⅣMonteggia fracture were retrospectively analyzed,and the patients were divided into the thrombotic group(35 cases)and the non-thrombotic group(193 cases)by B-ultrasound examination of the occurrence of DVT within 2 weeks postoperatively.The clinical data of the two groups were compared,and a multifactorial Logistic analysis of the occurrence of DVT after typeⅣMonteggia fracture was performed.Results There was no statistically significant difference between the two groups in terms of gender,percentage of coronary heart disease,percentage of cerebral infarction and preoperative hemoglobin,mean platelet volume(MPV),glutamate pyruvic transaminase,glutamic oxalacetic transaminase and uric acid levels(P>0.05).In the thrombotic group,the mean age was(46.70±8.10)years old,the body mass index(BMI)was(23.30±4.50)kg/m^(2),25 cases had a history of smoking and drinking,15 cases had hypertension and 16 cases had diabetes mellitus,the operative time was(114.52±30.89)min,5 cases had anticoagulant drugs postoperatively;the intraoperative blood loss was(122.85±18.74)ml,the postoperative blood loss was(139.56±21.09)ml,the preoperative platelet(PLT)count was(155.74±64.42)×10^(9)/L,the preoperative creatinine was(72.80±28.55)μmol/L,the preoperative plasma D-dimer was(13.49±9.77)mg/L,the preoperative thrombin time was(21.09±1.01)s and the preoperative activated partial thrombin time was(21.58±0.87)s.In the non-thrombotic group,the mean age was(30.50±7.20)years old,the BMI was(21.60±4.20)kg/m^(2),35 cases had a history of smoking and drinking,31 cases had hypertension and 35 cases had diabetes mellitus,the operative time was(104.68±26.42)min,120 cases had anticoagulant drugs postoperatively;the intraoperative blood loss was(61.18±12.69)ml,the postoperative blood loss was(64.25±15.56)ml,the preoperative PLT count was(183.19±70.99)×10^(9)/L,t

关 键 词：孟氏骨折 深静脉血栓形成 D-二聚体 LOGISTIC回归模型 

分 类 号：R687.3[医药卫生—骨科学]