影响腰硬联合麻醉下子宫肌瘤剔除术患者DVT发生的相关因素分析  

Related factors analysis of the incidence of the deep vein thrombosis of patients with hysteromyomectomy under the combined spinal epidural anesthesia

作　　者：周春娜[1] 周学武[1] ZHOU Chunna;ZHOU Xuewu(Daqing Longnan Hospital,Daqing,Heilongjiang Province,163453)

机构地区：[1]黑龙江省大庆龙南医院,163453

出　　处：《中国计划生育学杂志》2024年第11期2620-2624,共5页Chinese Journal of Family Planning

摘　　要：目的:探究影响腰硬联合麻醉下子宫肌瘤剔除术患者深静脉血栓(DVT)发生的相关因素。方法:收集2021年1月-2024年1月本院就诊行腰硬联合麻醉下子宫肌瘤剔除术患者200例,根据术后有无DVT分为DVT组和无DVT组,统计一般资料、实验室指标、手术情况、术后情况等,分析腰硬联合麻醉下子宫肌瘤剔除术患者发生DVT的相关因素。结果:200例术后发生DVT 24例(12.0%)。两组年龄、吸烟、合并高血压、合并血脂紊乱、术前美国麻醉医师协会(ASA)分级、最大肌瘤位置、剔除肌瘤数、手术时间比较无差异(P>0.05);DVT组体质指数(BMI)、合并糖尿病占比、术前D-二聚体、最大肌瘤直径、术中气腹压、术后血红蛋白水平、术后卧床时间水平均高于无DVT组(P<0.05)。多因素logistic回归分析显示,BMI大、合并糖尿病、术前D-二聚体水平高、最大肌瘤直径大、术中气腹压高、术后血红蛋白水平高、术后卧床时间长是腰硬联合麻醉下子宫肌瘤剔除术患者发生DVT的独立危险因素(均P<0.05)。结论:腰硬联合麻醉下子宫肌瘤剔除术患者发生DVT的相关因素较多,临床应重视对DVT高危患者的识别,给予针对性干预。Objective:To explore the related factors of the incidence of the deep vein thrombosis(DVT)of patients with hysteromyomectomy under the combined spinal epidural anesthesia.Methods:From January 2021 to January 2024,200 patients who had undergone the hysteromyomectomy under the combined spinal epidural anesthesia were included and were divided into group A(patients with DVT)and group B(patients without DVT)according to the absence or presence the occurrence of DVT after surgery.The general data,the laboratory indicators values,the operative and postoperative conditions of the patients in the two groups were recorded.The relevant factors of the DVT occurrence of the patients with hysteromyomectomy under the combined spinal epidural anesthesia were analyzed.Results:In 200 patients,there were 24(12.0%)patients with DVT occurred.There were no significant differences in the age,the smoking,the complication with hypertension or dyslipidemia,the preoperative myoma of uterus classification evaluated by American society of anesthesiologists(ASA),the largest location,the myoma number by hysteromyomectomy and the operation time of the patients between the two groups(P>0.05).The body mass index(BMI),the proportion of diabetes mellitus,the preoperative D-dimer level,the maximum myoma diameter,the intraoperative pneumoperitoneum pressure value,and the postoperative hemoglobin level and bed rest time of the patients in group A were significantly higher than those of the patients in group B(P<0.05).Multivariate logistic regression analysis showed that the high BMI,the diabetes,the high preoperative D-dimer level,the large maximum myoma diameter,the high intraoperative pneumoperitoneum pressure,the high postoperative hemoglobin level,and the long postoperative bed rest time of the patients were the independent risk factors of the DVT occurrence of the patients with the uterine myomectomy under combined spinal and epidural anesthesia(all P<0.05).Conclusion:There are many related factors of the DVT occurrence of the patients with the

关 键 词：子宫肌瘤剔除术 腰硬联合麻醉 深静脉血栓 相关因素 

分 类 号：R737.33[医药卫生—肿瘤] R614[医药卫生—临床医学]