脓毒症患者重症监护室内发生下肢深静脉血栓的危险因素  

Risk factors of lower extremity deep vein thrombosis in patients with sepsis in the intensive care unit

作　　者：张维[1] 宋长莉 曹敏 朱立娟 谢静 Zhang Wei;Song Changli;Cao Min;Zhu Lijuan;Xie Jing(Department of Critical Care Medicine,Fu Xing Hospital,Capital Medical University,Beijing 100038,China;Department of Vascular Surgery,Fu Xing Hospital,Capital Medical University,Beijing 100038,China)

机构地区：[1]首都医科大学附属复兴医院重症医学科,北京100038 [2]首都医科大学附属复兴医院血管外科,北京100038

出　　处：《血管与腔内血管外科杂志》2023年第7期815-819,共5页Journal of Vascular and Endovascular Surgery

摘　　要：目的探讨脓毒症患者重症监护室(ICU)住院期间发生下肢深静脉血栓(DVT)的危险因素。方法收集2019年1月至2019年12月于首都医科大学附属复兴医院住院治疗的126例脓毒症患者的临床资料,根据ICU住院期间是否发生下肢DVT将患者分为DVT组(n=35)和对照组(n=91)。采用多因素Logistic回归模型分析脓毒症患者ICU住院期间发生下肢DVT的危险因素。结果DVT组患者的年龄明显大于对照组患者,进行机械通气的比例、ICU住院期间手术的比例均高于对照组患者,而使用低分子肝素的比例低于对照组患者,差异均有统计学意义(P﹤0.05)。两组患者持续肾脏替代治疗、使用糖皮质激素、输注血小板、深静脉置管的比例比较,差异均无统计学意义(P﹥0.05)。多因素分析结果显示,年龄≥60岁、进行机械通气、ICU住院期间手术均是脓毒症患者ICU住院期间发生下肢DVT的独立危险因素(OR﹥1,P﹤0.05),而使用低分子量肝素是脓毒症患者ICU住院期间发生下肢DVT的保护因素(OR﹤1,P﹤0.05)。结论年龄≥60岁、进行机械通气、进行手术治疗、使用低分子量肝素均与脓毒症患者ICU住院期间发生下肢DVT密切相关,临床中应注意及时评估脓毒症患者ICU住院期间发生下肢DVT的风险,并做好预防和监测。Objective To investigate the risk factors of lower extremity deep vein thrombosis(DVT)in the intensive care unit(ICU)of sepsis patients.Method The clinical data of 126 patients with sepsis hospitalized in Fu Xing Hospital,Capital Medical University from January 2019 to December 2019 were collected,patients were divided into DVT group(n=35)and control group(n=91)according to whether lower extremity DVT occurred during ICU hospitalization.The risk factors of lower extremity DVT during ICU hospitalization in patients with sepsis were analyzed by multivariate logistic regression model.Result The patients in the DVT group were significantly older than those in the control group,and the proportions of receiving mechanical ventilation and surgery during ICU hospitalization were higher than those in the control group,while the proportion of patients receiving low molecular weight heparin was lower than that of the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the proportions of continuous renal replacement therapy,glucocorticoid use,platelet transfusion,and deep vein catheterization between the two groups(P>0.05).The results of multivariate analysis showed that age≥60 years old,mechanical ventilation,and surgery during ICU hospitalization were all independent risk factors for lower extremity DVT during ICU hospitalization in patients with sepsis(OR>1,P<0.05),while the use of low molecular weight heparin was a protective factor for lower extremity DVT during ICU hospitalization in patients with sepsis(OR<1,P<0.05).Conclusion Age≥60 years,mechanical ventilation,surgical treatment,and low molecular weight heparin were all closely related to lower extremity DVT during ICU hospitalization in sepsis patients.Great attention should be paid to promptly assessing the risk of lower extremity DVT during ICU hospitalization in patients with sepsis,and making all-round preparations for prevention and monitoring in clinical practice.

关 键 词：脓毒症 重症监护室 深静脉血栓 机械通气 危险因素 

分 类 号：R543[医药卫生—心血管疾病]