摘要
目的探讨股骨粗隆间骨折手术后早期发生下肢深静脉血栓的危险因素,并进行Nomogram模型构建。方法选取2018年1月—2020年12月于华北石油管理局总医院行股骨粗隆间骨折手术的120例患者,术后早期发生下肢深静脉血栓13例。按照术后住院期间是否发生下肢深静脉血栓分为并发症组和无并发症组。采用多因素Logistics分析术后发生并发症的风险并构建Nomogram模型。结果并发症组患者住院时长、术后住院时间、治疗总费用均高于对照组,差异有统计学意义(P<0.05)。单因素分析显示,骨折类型、合并慢性病种类、贫血输血、骨折发病时长是术后下肢深静脉血栓的潜在影响因素,差异有统计学意义(P<0.05)。将单因素有统计学差异的变量进行Logistics多因素分析,合并慢性病种类、贫血输血、骨折发病时长是股骨粗隆间骨折术后下肢深静脉血栓的独立危险因素(P<0.05)。采用内部数据进行验证,C-index为0.746(95%CI:0.596~0.935),该Nomogram模型预测与实际观测结果吻合度较好。结论术前合并慢性病≥3种、贫血输血、骨折发病时长>1 d是股骨粗隆间骨折术后下肢深静脉血栓的独立危险因素。本研究构建的Nomogram模型有助于指导医师完善个性化围手术期治疗方案。
Objective To Exploring the risk factors for early occurrence of deep vein thrombosis in the lower limbs after surgery for intertrochanteric fractures of the femur,and to construct Nomogram model.Methods All 120 patients,who underwent surgery for intertrochanteric fractures of the femur,were selected from January 2018 to February 2020.Thirteen cases of early postoperative deep vein thrombosis in the lower limbs occurred.The patients were divided into a complication group and a control group based on whether deep vein thrombosis occurred during postoperative hospitalization.Using multivariate logistic analysis to assess the risk of postoperative complications and constructing a Nomogram model.Results hospitalization time postoperative hospitalization time,and total treatment cost of patients in the complication group were higher than those in the control group(P<0.05).Univariate analysis showed that fracture type,number of concurrent chronic diseases,anemia transfusion,and duration of fracture onset were potential influencing factors for postoperative deep vein thrombosis in the lower limbs,with statistically significant differences(P<0.05).Logistic multivariate analysis showed that the number of concurrent chronic diseases,anemia transfusion,and duration of fracture onset were independent risk factors for lower limb deep vein thrombosis after surgery for intertrochanteric fractures of the femur(P<0.05).The C-index was 0.746(95%CI:0.596-0.935),indicating that the Nomogram model fitted well with the actual observation results.Conclusion The independent risk factors for postoperative deep vein thrombosis in the lower limbs of intertrochanteric fractures include number of chronic diseases(≥3 types),blood transfusion,and fracture onset time(>1 day).The Nomogram model constructed in this study helps guide physicians in improving personalized perioperative treatment plans.
作者
赵宇宙
杨利谦
黄晓洁
ZHAO Yuzhou;YANG Liqian;HUANG Xiaojie(Department of Orthopedics,North China Petroleum Administration General Hospital,Renqiu Hebei 062552,China)
出处
《中国急救复苏与灾害医学杂志》
2024年第6期807-810,共4页
China Journal of Emergency Resuscitation and Disaster Medicine
基金
河北省医学科学研究课题计划(项目:20190287)。
关键词
股骨粗隆间骨折
深静脉血栓
并发症
危险因素
Nomogram模型
Femur intertrochanteric fracture
Deep venous thrombosis in lower extremity
Complication
Risk factors
Nomogram model
