髋部手术患者术后深静脉血栓危险因素的Meta分析  

A Meta-analysis of the risk factors of deep venous thrombosis in patients undergoing hip surgery

作　　者：王叶婷 刘平芳 孙玉颖 魏诗意 张珍 WANG Yeting;LIU Pingfang;SUN Yuying;WEI Shiyi;ZHANG Zhen(Jishou University School of Medicine,Jishou 416000,Hunan Province,China;The Fourth Clinical College of Jishou University,Hunan University of Medicine General Hospital,Huaihua 418000,Hunan Province,China)

机构地区：[1]吉首大学医学院,湖南吉首416000 [2]吉首大学第四临床学院/湖南医药学院总医院,湖南怀化418000

出　　处：《医学新知》2024年第12期1378-1394,共17页New Medicine

基　　金：湖南省自然科学基金(区域联合基金)(2024JJ7345)。

摘　　要：目的通过Meta分析明确髋部手术患者术后引发下肢深静脉血栓(deep venous thrombosis,DVT)形成的危险因素。方法计算机检索The Cochrane Library、Web of Science、PubMed、Embase、中国知网、维普、万方以及中国生物医学文献数据库关于髋部手术后患者发生DVT危险因素的研究,检索时间范围为建库至2024年3月28日。按照纳入排除标准由2名研究者独立筛选文献、提取资料以及评价文献质量。采用RevMan5.4软件进行Meta分析。结果共纳入36篇文献,其中30篇病例对照研究、6篇队列研究,样本量为83902例,涉及55项危险因素。Meta分析结果显示,高龄[OR=2.11,95%CI(1.70,2.64)]、女性[OR=2.35,95%CI(1.57,3.51)]、患有糖尿病[OR=2.03,95%CI(1.66,2.49)]、高血压[OR=2.67,95%CI(1.86,3.84)]、合并下肢静脉病变[OR=4.30,95%CI(2.74,6.74)]、全身麻醉[OR=2.02,95%CI(1.38,2.95)]、手术时间长[OR=2.46,95%CI(1.82,3.31)]、术后卧床时间>2 d[OR=3.60,95%CI(1.95,6.65)]、合并血液高凝[OR=3.47,95%CI(1.67,7.21)]、感染[OR=5.04,95%CI(3.45,7.37)],以及D-二聚体[OR=1.88,95%CI(1.24,2.84)]、BMI[OR=2.44,95%CI(1.88,3.17)]、甘油三酯[OR=2.51,95%CI(1.32,4.77)]水平升高是髋部手术患者术后发生DVT的独立危险因素。结论在髋部手术中,高龄、女性、患有糖尿病、高血压、合并下肢静脉病变、全身麻醉、手术时间长、术后卧床时间>2 d、合并血液高凝、感染、BMI、D-二聚体、甘油三酯水平升高均是影响患者术后DVT的危险因素,因此,针对这些危险因素,应采取及时有效的预防措施和监测方法以降低髋部手术术后DVT的发生率。Objective To identify the risk factors for deep venous thrombosis(DVT)in patients undergoing hip surgery by Meta-analysis.Methods The Cochrane Library,Web of Science,PubMed,Embase,CNKI,VIP,WanFang and SinoMed databases were searched for the risk factors of DVT in patients undergoing hip surgery.The search period was from inception of the database to March 28,2024.According to certain inclusion and exclusion criteria,two researchers independently screened the literature,extracted data and evaluated the literature quality.RevMan5.4 software was used to conduct the Meta-analysis.Results A total of 36 articles were included,including 30 case-control studies and 6 cohort studies,with a sample size of 83,902 cases.These included 55 risk factors.The results of Meta-analysis showed that advanced age[OR=2.11,95%CI(1.70,2.64)],female[OR=2.35,95%CI(1.57,3.51)],diabetes[OR=2.03,95%CI(1.66,2.49)],hypertension[OR=2.67,95%CI(1.86,3.84)],combined lower extremity venous disease[OR=4.30,95%CI(2.74,6.74)],method of anesthesia[OR=2.02,95%CI(1.38,2.95)],long operation duration[OR=2.46,95%CI(1.82,3.31)],postoperative bed time>2 d[OR=3.60,95%CI(1.95,6.65)],combined with blood hypercoagulability[OR=3.47,95%CI(1.67,7.21)],infection[OR=5.04,95%CI(3.45,7.37)],elevated D-dimer[OR=1.88,95%CI(1.24,2.84)],elevated BMI[OR=2.44,95%CI(1.88,3.17)],elevated triglyceride level[OR=2.51,95%CI(1.32,4.77)]were independent risk factors for DVT in patients undergoing hip surgery.Conclusion In hip surgery,advanced age,female,diabetes mellitus,hypertension,lower limb venous disease,anesthesia mode,long operation duration,postoperative bed time>2 d,blood hypercoagulability,infection,elevated BMI,elevated D-dimer,elevated triglyceride level are risk factors affecting postoperative DVT.Therefore,it is important to take effective preventive measures and monitoring methods in time to reduce the incidence of DVT after hip surgery.

关 键 词：髋部手术 深静脉血栓 危险因素 META分析 

分 类 号：R543[医药卫生—心血管疾病]