摘要
目的:探讨脊髓损伤(SCI)患者使用四肢血液循环泵治疗期间发生下肢深静脉血栓(DVT)形成的独立危险因素。方法:收集2016年1月至2018年12月绍兴市中心医院脊柱外科收治的胸腰段脊柱骨折伴SCI患者300例,于手术后使用四肢血液循环泵预防DVT,48例发生DVT的患者归为DVT组,其余252例归为非DVT组。收集所有患者的基本信息(性别、年龄、身高、体质量等)、体质指数(BMI)、慢性疾病情况(糖尿病、高血压、冠心病等)、吸烟史、是否合并下肢骨折、SCI分类、手术时间、术中出血量等相关因素,分析上述因素在DVT组与非DVT组之间的差异是否具有统计学意义。将具有统计学意义的变量代入logistic回归分析,找出导致SCI患者使用四肢血液循环泵治疗期间发生DVT的独立危险因素。结果:DVT组高龄(≥60岁)患者的比例(79.17%)高于非DVT组(57.14%)(χ 2=8.196, P=0.004),肥胖(BMI≥25 kg/m 2)患者的比例(77.08%)高于非DVT组(56.35%)(χ 2=7.203, P=0.007),合并糖尿病患者的比例(68.75%)高于非DVT组(10.71%)(χ 2=84.877, P=0.000),吸烟患者的比例(81.25%)高于非DVT组(49.21%)(χ 2=16.685, P=0.000),合并下肢骨折患者的比例(41.67%)高于非DVT组(7.14%)(χ 2=43.443, P=0.000),完全性损伤患者的比例(45.83%)高于非DVT组(15.08%)(χ 2=23.834, P=0.000)。logistic回归分析显示,合并糖尿病、吸烟史、合并下肢骨折为导致SCI患者使用四肢血液循环泵治疗期间发生DVT的独立危险因素( OR=1.138、1.356、1.548, P=0.003、0.007、0.014)。 结论:在SCI患者使用四肢血液循环泵期间发生DVT的独立危险因素可能有合并糖尿病、吸烟史和合并下肢骨折。
Objective To investigate the independent risk factors of deep venous thrombosis(DVT)in patients with spinal cord injury(SCI)treated with limb blood circulation pump.Methods From January 2016 to December 2018,300 patients of thoracolumbar spine fractures with SCI were collected in the department of spinal surgery of Shaoxing Central Hospital.The patients received blood circulation pump to prevent DVT after operation,48 patients with DVT were classified as DVT group,and the remaining 252 patients were classified as non-DVT group.The basic information(sex,age,height,weight,etc.),body mass index(BMI),chronic disease status(diabetes,hypertension,coronary heart disease,etc.),smoking history,combined lower extremity fracture,SCI classification,operation time,intraoperative blood loss were collected.The differences of above indicators between the DVT group and the non-DVT group were analyzed.The factors with statistical differences were substituted into logistic regression analysis to identify independent risk factors for DVT in patients with SCI who were treated with blood circulation pump.Results The proportion of elderly patients(≥60 years old)in the DVT group was higher than that in the non-DVT group(79.17%vs.57.14%,χ2=8.196,P=0.004),and the proportion of obese patients(BMI≥25kg/m2)in the DVT group was higher than that in the non-DVT group(77.08%vs.56.35%,χ2=7.203,P=0.007),the proportion of patients with diabetes in the DVT group was higher than that in the non-DVT group(68.75%vs.10.71%,χ2=84.877,P=0.000),the proportion of smokers in the DVT group was higher than that in the non-DVT group(81.25%vs.49.21%,χ2=16.685,P=0.000),the proportion of patients with lower extremity fractures in the DVT group was higher than that in the non-DVT group(41.67%vs.7.14%,χ2=43.443,P=0.000),and the proportion of patients with complete injury in the DVT group was higher than that in the non-DVT group(45.83%vs.15.08%,χ2=23.834,P=0.000).Logistic regression analysis showed that diabetes,smoking history and lower extremity fractures were independent risk factors for DVT in SCI patients with limb blood circulation pump(Or=1.138,1.356,1.548,P=0.003,0.007,0.014).Conclusion The independent risk factors for DVT in SCI patients when using blood circulation pump may include diabetes,smoking history and lower extremity fractures.
作者
俞英英
谢黎
Yu Yingying;Xie Li(Department of ICU,Shaoxing Central Hospital,Shaoxing,Zhejiang 312030,China)
出处
《中国基层医药》
CAS
2020年第7期841-845,共5页
Chinese Journal of Primary Medicine and Pharmacy
关键词
脊髓损伤
胸腰段脊柱骨折
四肢血液循环泵
下肢深静脉血栓
糖尿病
吸烟史
下肢骨折
独立危险因素
Spinal cord injury
Thoracolumbar spine fracture
Limb blood circulation pump
Lower extremity deep vein thrombosis
Diabetes mellitus
Smoking history
Lower limb fracture
Independent risk factor
