急性脑出血患者下肢深静脉血栓形成的危险因素分析  

Risk Factors of Lower Extremity Deep Vein Thrombosis in Patients with Acute Intracerebral Hemorrhage

作　　者：郑昕 郭军平[1] 张润华[1] 冀瑞俊[1] ZHENG Xin;GUO Junping;ZHANG Runhua;JI Ruijun(Department of Neurology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院神经病学中心,北京100070

出　　处：《中国卒中杂志》2023年第5期577-582,共6页Chinese Journal of Stroke

摘　　要：目的分析急性脑出血患者住院期间下肢深静脉血栓形成(deep venous thrombosis,DVT)发生率、发生时间及危险因素。方法选取首都医科大学附属北京天坛医院急性卒中入院后并发症队列研究中的脑出血患者,根据患者住院期间是否发生下肢DVT分为DVT组和无DVT组,比较两组患者的临床特征,采用多因素logistic回归分析脑出血患者发生DVT的危险因素。结果研究最终纳入314例脑出血患者,其中18例(5.7%)住院期间发生了DVT,发生脑出血至DVT确诊的中位时间为7.5(4.0~9.0)d。多因素logistic回归分析结果显示:女性(OR 3.43,95%CI 1.04~11.37,P=0.0436)、既往冠心病病史(OR 6.89,95%CI 1.90~25.04,P=0.0034)、入院NIHSS评分高(OR 1.18,95%CI 1.06~1.23,P=0.0004)、住院时间长(OR 1.07,95%CI 1.01~1.13,P=0.0273)是脑出血患者发生DVT的独立危险因素。结论急性脑出血患者发生下肢DVT时间在卒中后1周左右,女性、既往冠心病病史、入院时病情重、住院时间长的患者更容易发生下肢DVT。Objective To analyze the incidence,occurrence time and risk factors of deep vein thrombosis(DVT)in patients with acute intracerebral hemorrhage(ICH)during hospitalization.Methods Patients with ICH from the In-hospital medical Complications after Acute Stroke Study of Beijing Tiantan Hospital,Capital Medical University were selected.The patients were divided into two groups according to whether DVT of lower limbs occurred during hospitalization(DVT group)and no DVT group(non-DVT group).The clinical characteristics of the two groups were compared,and the risk factors of DVT in patients with ICH were analyzed by multivariate logistic regression.Results A total of 314 patients with ICH were included in this study.Among them,18 patients(5.7%)developed DVT during hospitalization,and the time from onset of ICH to diagnosis of DVT was 7.5(4.0-9.0)days.The results of multivariate analysis showed that female(OR 3.43,95%CI 1.04-11.37,P=0.0436),history of coronary heart disease(OR 6.89,95%CI 1.90-25.04,P=0.0034),high NIHSS score at admission(OR 1.18,95%CI 1.06-1.23,P=0.0004)and long hospital stay after onset(OR 1.07,95%CI 1.01-1.13,P=0.0273)were independent risk factors for DVT in patients with ICH.Conclusions The DVT time of patients with acute intracerebral hemorrhage is about 1 week after stroke,and the patients who were more prone to lower extremity DVT were female,had a history of coronary heart disease,were seriously ill at admission,and had a long hospital stay.

关 键 词：脑出血 深静脉血栓形成 发生时间 发生率 危险因素 

分 类 号：R743.34[医药卫生—神经病学与精神病学]