抗凝在PKP围手术期血栓防治中的价值及相关危险因素分析  

Value of anti-coagulation in prevention and treatment of thrombosis during PKP perioperative period and analysis of related risk factors

作　　者：傅旭东 刘江涛[3] Fu Xudong;Liu Jiangtao(Medical School of Ningbo University,Ningbo,Zhejiang 315000,China;Department of General Surgery,Ningbo Hospital,Renji Hospital Affiliated to School of Medicine,Shanghai Jiaotong University,Ningbo,Zhejiang 315000,China;Department of Spine Surgery,the Second Hospital of Ningbo,Ningbo,Zhejiang 315000,China)

机构地区：[1]宁波大学医学部,浙江宁波315000 [2]上海交通大学医学院附属仁济医院宁波医院普通外科 [3]宁波市第二医院脊柱外科

出　　处：《齐齐哈尔医学院学报》2024年第6期548-550,共3页Journal of Qiqihar Medical University

摘　　要：目的 探讨老年患者接受PKP治疗围手术期下肢深静脉血栓形成的危险因素,及抗凝治疗在深静脉血栓形成中的保护作用。方法 回顾性分析××市第二医院骨科中心选择2021年3月到2023年3月收治的老年压缩性骨折接受经皮椎体球囊后凸成形术治疗的430例患者临床资料。根据术后是否发生下肢深静脉血栓,分为血栓组和非血栓组,采用单因素和多因素logistic回归分析得出下肢深静脉血栓形成的危险因素和保护因素。结果 430例患者中,围术期共发生下肢深静脉血栓46例(10.7%)。单因素分析,两组间患者年龄、性别比、高血压、糖尿病、高血脂、肥胖(BMI≥25)、手术时间以及术前血小板、纤维蛋白原、D-二聚体计数是否升高等比较,差异均无统计学意义(P>0.05)。围手术期是否抗凝、术后制动时间是否大于24 h两组间血栓发生率比较,差异具有统计学意义(P<0.05)。多因素二元Logistic回归分析显示:术后制动时间大于24 h是发生下肢深静脉血栓的危险因素,围手术期抗凝是预防术后下肢深静脉血栓发生的保护性因素。结论 术后早期下床活动、围手术期给予预防性抗凝有助于降低经皮椎体球囊后凸成形术患者术后下肢深静脉血栓的发生率。Objective To investigate the risk factors of perioperative deep vein thrombosis(DVT)in elderly patients receiving treatment of PKP,and the protective effect of anticoagulant therapy on DVT.Methods The clinical data of 430 elderly patients suffering from compressive fractures who received percutaneous kyphoplasty in the orthopaedic center of Ningbo Second Hospital in the past two years were retrospectively analyzed.According to whether there was deep vein thrombosis of lower limbs after surgery,the patients were divided into the thrombosis group and the non thrombosis group.The risk factors and protective factors of deep vein thrombosis of lower limbs were obtained by single factor and multi factor logistic regression analysis.Results Among 430 patients,46 patients(10.7%)suffered from deep vein thrombosis of lower limbs during perioperative period.Univariate analysis showed that there were no significant difference between the two groups in age,sex ratio,hypertension,diabetes,hyperlipidemia,obesity(BMI≥25),operation time,and whether the preoperative platelet,fibrinogen,D-dimer counts increased(P>0.05).There was a statistically significant difference in the incidence of thrombosis between the two groups.Whether anti-coagulation was performed during the perioperative period and whether the postoperative immobilization time was greater than 24 hours(P<0.05).Multivariate binary logistic regression analysis showed that immobilization time(greater than 24 hours after surgery)was a risk factor for lower limb deep vein thrombosis,and perioperative anti-coagulation was a protective factor to prevent lower limb deep vein thrombosis.Conclusions Early ambulation and perioperative prophylactic anti-coagulation are helpful to reduce the incidence of lower limb deep vein thrombosis after percutaneous kyphoplasty.

关 键 词：腰椎压缩性骨折 经皮椎体球囊后凸成形术 深静脉血栓 危险因素 抗凝 

分 类 号：R543.6[医药卫生—心血管疾病]