摘要
目的研究高龄老年髋部骨折患者术前下肢深静脉血栓(deep vein thrombosis,DVT)形成的危险因素。方法回顾性研究2018年3月至2019年2月北京积水潭医院老年创伤骨科病房收治的687例80岁以上的高龄老年髋部骨折患者。通过多普勒超声对下肢DVT进行初筛,可疑或阳性的患者行静脉造影确诊DVT。通过单因素和多因素逐步Logistic回归分析,探讨术前下肢DVT的独立危险因素。结果高龄老年髋部骨折术前下肢DVT发生率为12.4%(85/687)。经过多因素逐步Logistic回归分析得出受伤至入院时间、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、股骨粗隆间骨折是高龄老年髋部骨折术前下肢DVT的独立预测因子(P<0.05)。结论高龄老年髋部骨折患者术前下肢DVT的发生率高,股骨粗隆间骨折、骨折后延迟入院以及APTT缩短的患者术前下肢DVT的发生率增加,对有这些危险因素的患者应采取预防措施,以降低术前DVT的发生率。
Objective To study the risk factors of deep venous thrombosis(DVT)of lower extremity in elderly patients with hip fracture.Methods A retrospective study was conducted on 687 elderly patients over 80 years with hip fracture admitted to the Orthopaedic Trauma ward for the elderly of Beijing Jishuitan Hospital from March 2018 to February 2019.Lower extremity DVT was initially screened by doppler ultrasound,and patients with suspected or positive lower extremity DVT were diagnosed by venography.Univariate and multivariate stepwise Logistic regression analysis was performed to explore the independent risk factors of DVT in lower extremities before surgery.Results The incidence of preoperative lower limb DVT was 12.4%(85/687).Independent predictors of preoperative DVT identified by multivariate stepwise Logistic regression analyses were time from injury to admission,activated partial thromboplastin time(APTT)and intertrochanteric fracture(P<0.05).Conclusion The incidence of DVT in lower extremity is high in elderly patients with hip fracture.Patients with intertrochanteric fractures,delayed admission after fracture,and shortened APTT have an increased incidence of preoperative lower limb DVT.We should take preventive measures for patients with these risk factors to reduce the incidence of preoperative DVT.
作者
岳睿
李晓玉
杨明辉
刘晓艳
范斌
张萍
Yue Rui;Li Xiaoyu;Yang Minghui;Liu Xiaoyan;Fan Bin;Zhang Ping(Department of Cadre Health Care,Beijing Jishuitan Hospital,Beijing 100035,China;Department of Traumatic Orthopedics,Beijing Jishuitan Hospital,Beijing 100035,China)
出处
《首都医科大学学报》
CAS
北大核心
2020年第3期458-463,共6页
Journal of Capital Medical University
基金
首都卫生发展科研专项(首发2018-1-2071)。
关键词
下肢深静脉血栓形成
髋部骨折
高龄老年
lower extremity deep vein thrombosis
hip fracture
elderly patients
