急性缺血性脑卒中患者rt-PA静脉溶栓后深静脉血栓的危险因素分析  

Analysis of risk factors for deep venous thrombosis after rt-PA intravenous thrombolysis in patients with acute ischemic stroke

作　　者：林燕萍 刘芳[1] 华美芳 张纯真[2] 胡春霞[2] 陈星宇[2] LIN Yanping;LIU Fang;HUA Meifang;ZHANG Chunzhen;HU Chunxia;CHEN Xingyu(College of Nursing,Fujian University of Traditional Chinese Medicine,Fuzhou,Fujian 350012,China;Department of Neurology,Zhongshan Hospital Affiliated to Xiamen University,Xiamen,Fujian 361004,China)

机构地区：[1]福建中医药大学护理学院,福建福州350012 [2]厦门大学附属中山医院神经内科,福建厦门361004

出　　处：《现代医药卫生》2024年第12期2062-2067,共6页Journal of Modern Medicine & Health

摘　　要：目的 探讨急性缺血性脑卒中(AIS)患者重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓后深静脉血栓(DVT)的发生率及危险因素。方法 回顾性分析2019年9月至2023年10月在该院行rt-PA静脉溶栓治疗的AIS患者的临床资料。采用单因素、logistic回归分析rt-PA溶栓后下肢DVT的影响因素。结果 共纳入172例患者,其中,35例(20.3%)发生下肢DVT。年龄和D-二聚体是AIS患者rt-PA静脉溶栓后发生DVT的危险因素[比值比(OR)=1.054,95%可信区间(95%CI)1.008~1.103,P<0.05和OR=1.082,95%CI 1.007~1.163,P<0.05];甘油三酯和活化部分凝血活酶时间是保护因素(OR=0.622,95%CI 0.392~0.988,P<0.05和OR=0.813,95%CI 0.681~0.972,P<0.05)。结论 AIS患者rt-PA静脉溶栓后下肢DVT的发病率较高,年龄、D-二聚体、甘油三酯和活化部分凝血活酶时间是影响因素,护理人员应及时识别高危患者,并制订相应的干预措施。Objective To investigate the incidence and risk factors of deep venous thrombosis(DVT)after intravenous thrombolysis with recombinant tissue plasminogen activator(rt-PA)in patients with acute ischemic stroke(AIS).Methods The clinical data of AIS patients who underwent rt-PA intravenous thrombolysis in the hospital from September 2019 to October 2023 were retrospectively analyzed.Univariate and logistic regression were used to analyze the influencing factors of lower extremity DVT after rt-PA thrombolysis.Results A total of 172 patients were included,of which 35(20.3%)developed lower extremity DVT.Age and D-dimer were risk factors for DVT after rt-PA intravenous thrombolysis in AIS patients(OR=1.054,95%CI 1.008-1.103,P<0.05;OR=1.082,95%CI 1.007-1.163,P<0.05).Triglyceride and activated partial thromboplastin time were protective factors(OR=0.622,95%CI 0.392-0.988,P<0.05;OR=0.813,95%CI 0.681-0.972,P<0.05).Conclusion The incidence of lower extremity DVT after rt-PA intravenous thrombolysis in AIS patients is high.Age,D-dimer,triglyceride and activated partial thromboplastin time are influencing factors.Nursing staff should identify high-risk patients in time and formulate corresponding intervention measures.

关 键 词：急性缺血性脑卒中 深静脉血栓 危险因素 重组组织型纤溶酶原激活剂 溶栓治疗 

分 类 号：R741[医药卫生—神经病学与精神病学]