脑卒中偏瘫患者下肢深静脉血栓的发生情况及其危险因素分析  

Analysis of the incidence and risk factors of lower extremity deep vein thrombosis in stroke patients with hemiplegia

作　　者：王云鑫 宋宇[1] 周立华[1] 黄欢欢[1] 潘易飞 Wang Yunxin;Song Yu;Zhou Lihua;Huang Huanhuan;Pan Yifei(Department of Neurology,the First Affiliated Hospital of Harbin Medical University,Harbin 150000,Heilongjiang,China;Department of Vascular Surgery,the First Affiliated Hospital of Harbin Medical University,Harbin 150000,Heilongjiang,China)

机构地区：[1]哈尔滨医科大学附属第一医院神经内科,黑龙江哈尔滨150000 [2]哈尔滨医科大学附属第一医院血管外科,黑龙江哈尔滨150000

出　　处：《血管与腔内血管外科杂志》2024年第3期357-361,共5页Journal of Vascular and Endovascular Surgery

摘　　要：目的 探讨脑卒中偏瘫患者下肢深静脉血栓(DVT)的发生情况及其危险因素。方法 收集2021年1月至2022年12月于哈尔滨医科大学附属第一医院住院接受治疗的106例脑卒中偏瘫患者的临床资料,按照是否发生下肢DVT将患者分为DVT组(n=39)和对照组(n=67)。比较两组患者的临床特征、脑卒中病情,分析脑卒中偏瘫患者下肢DVT发生情况的危险因素。结果 DVT组患者的年龄大于对照组患者,吸烟史比例、D-二聚体水平、偏瘫时间≥1 d的比例、患肢肌力﹤3级的比例均高于对照组患者,差异均有统计学意义(P﹤0.05)。多因素分析结果显示,年龄≥65岁、有吸烟史、偏瘫时间≥1 d、D-二聚体水平≥500μg/L及患肢肌力﹤3级均为脑卒中偏瘫患者发生下肢DVT的独立危险因素(P﹤0.05)。结论 年龄、吸烟史、偏瘫时间、D-二聚体水平、患肢肌力均与脑卒中偏瘫患者发生下肢DVT密切相关,临床中应该对存在上述危险因素的脑卒中偏瘫患者给予重点观察,并给予积极的预防性治疗,以降低脑卒中偏瘫患者发生下肢DVT的风险。Objective To investigate the incidence and risk factors of lower extremity deep vein thrombosis(DVT)in stroke patients with hemiplegia.Method The clinical data of 106 stroke hemiplegic patients hospitalized in the First Affiliated Hospital of Harbin Medical University from January 2021 to December 2022 were collected and divided into DVT group(n=39)and control group(n=67)according to whether there was DVT in the lower extremities.The clinical characteristics and stroke severity of two groups of patients were compared,and the risk factors for lower extremity DVT in stroke patients with hemiplegia were analyzed.Result The age of patients in the DVT group was higher than that in the control group,and the proportion of smoking history,D-dimer level,the proportion of hemiplegia time≥1 d,and the proportion of affected extremity muscle strength<grade 3 were all higher than those in the control group,the differences were statistically significant(P<0.05).The results of multivariate analysis showed that age≥65 years old,smoking history,hemiplegia time≥1 d,D-dimer level≥500μg/L,and affected extremity muscle strength<grade 3 were all independent risk factors of stroke hemiplegia patients with lower extremity DVT(P<0.05).Conclusion Age,smoking history,duration of hemiplegia,D-dimer level and affected extremity muscle strength are closely related to the occurrence of lower extremity DVT in stroke patients with hemiplegia.In clinical practice,stroke hemiplegic patients with the above risk factors should be closely observed and given active preventive treatment to reduce the risk of lower extremity DVT in stroke hemiplegic patients.

关 键 词：脑卒中 偏瘫 下肢 深静脉血栓 危险因素 

分 类 号：R543[医药卫生—心血管疾病]