下肢大隐静脉曲张患者大隐静脉高位结扎剥脱术后并发VTE的危险因素分析  

Analysis of Risk Factors for VTE Complicating High Saphenous Vein Ligation and Stripping in Patients with Great Saphenous Vein Varices of the Lower Extremities

作　　者：吴远恩 WU Yuan'en(Department of General Surgery,WardⅠ,Wenshang County People's Hospital,Jining 272500,China)

机构地区：[1]汶上县人民医院普外科一病区,山东济宁272500

出　　处：《反射疗法与康复医学》2024年第24期110-113,共4页Reflexology And Rehabilitation Medicine

摘　　要：目的分析下肢大隐静脉曲张患者大隐静脉高位结扎剥脱术(HLS)后静脉血栓栓塞症(VTE)发生的危险因素。方法选取2020年3月—2024年3月于汶上县人民医院行大隐静脉HLS的198例下肢大隐静脉曲张患者为研究对象,统计其术后1个月内VTE发生情况,根据是否发生VTE分为发生组和未发生组。收集比较两组患者的临床病例资料,探讨患者大隐静脉HLS术后VTE发生的危险因素。结果198例下肢大隐静脉曲张患者中,大隐静脉HLS后发生的VTE有19例,VTE发生率为9.60%(19/198);单因素分析显示,两组年龄、糖尿病、术后是否使用低分子肝素、术前白蛋白水平、术中切口数量比较,组间差异有统计学意义(P<0.05);Logistic回归分析显示,年龄>60岁(OR=6.905,95%CI=2.198~21.693)、有糖尿病(OR=5.553,95%CI=1.910~16.145)、术后未使用低分子肝素(OR=8.237,95%CI=2.615~25.943)、术前白蛋白<35 g/L(OR=3.296,95%CI=1.197~9.073)、术中切口数量>7个(OR=3.796,95%CI=1.310~10.989)是下肢大隐静脉曲张患者大隐静脉HLS后VTE发生的独立危险因素(P<0.05且OR>1)。结论年龄>60岁、有糖尿病、术后未使用低分子肝素、术前白蛋白<35 g/L、术中切口数量>7个是下肢大隐静脉曲张患者大隐静脉HLS后VTE发生的高危因素。Objective To analyze the risk factors of venous thromboembolism(VTE)after high saphenous vein ligation and stripping(HLS)in patients with varicose saphenous vein of lower extremities.Methods A total of 198 patients with great saphenous varicose veins of the lower extremities,who underwent HLS of the great saphenous vein in Wenshang County People's Hospital from March 2020 to March 2024,were selected as the research subjects.The occurrence of VTE within 1 month after surgery was counted.The clinical data of the two groups were collected and compared to explore the risk factors for VTE after HLS in the great saphenous vein.Results Among 198 patients with varicose veins of lower extremities,19 patients developed VTE after HLS,and the incidence of VTE was 9.60%(19/198).Univariate analysis showed that there were significant differences between the two groups in age,diabetes,postoperative use of low molecular weight heparin,preoperative albumin level,and the number of intraoperative incisions(P<0.05).Logistic regression analysis showed that age>60 years(OR=6.905,95%CI=2.198~21.693),diabetes mellitus(OR=5.553,95%CI=1.910~16.145),no use of low molecular weight heparin after operation(OR=8.237,95%CI=2.615~25.943),preoperative albumin<35 g/L(OR=3.296,95%CI=1.197~9.073),the number of intraoperative incisions>7(OR=3.796,95%CI=1.310~10.989)were independent risk factors for VTE after HLS in patients with varicose saphenous vein of lower extremities(P<0.05 and OR>1).Conclusion Age>60 years,diabetes mellitus,no use of low molecular weight heparin after surgery,preoperative albumin<35 g/L,and the number of intraoperative incisions>7 are high risk factors for VTE after HLS in patients with varicose veins of lower limbs.

关 键 词：下肢大隐静脉曲张 大隐静脉高位结扎剥脱术 静脉血栓栓塞症 糖尿病 高血压 危险因素 

分 类 号：R543[医药卫生—心血管疾病]