| 脊髓损伤术后深静脉血栓形成的相关因素分析 |
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投稿时间：2019-05-20
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| 作者 | Author | 单位 | Address | E-Mail |
| 虞鑫 |
YU Xin |
平煤神马医疗集团总医院, 河南 平顶山 467000 |
Pingmei Shenma Medical Group General Hospital, Pingdingshan 467000, Henan, China |
1440946545@qq.com |
| 刘伟 |
LIU Wei |
平煤神马医疗集团总医院, 河南 平顶山 467000 |
Pingmei Shenma Medical Group General Hospital, Pingdingshan 467000, Henan, China |
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| 张豪伟 |
ZHANG Hao-wei |
平煤神马医疗集团总医院, 河南 平顶山 467000 |
Pingmei Shenma Medical Group General Hospital, Pingdingshan 467000, Henan, China |
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| 期刊信息：《中国骨伤》2020年，第33卷，第2期，第140-143页 |
| DOI：10.12200/j.issn.1003-0034.2020.02.010 |
| 基金项目: |
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中文摘要:
目的：初步探讨脊髓损伤术后深静脉血栓（DVT）形成的高危因素为预防DVT提供一定的参考价值。
方法：选取2016年1月至2017年12月因胸腰段椎体爆裂骨折致脊髓损伤的85例患者作为研究对象，所有患者随访6个月，其中失访5例，最终纳入80例。根据是否出现深静脉血栓分为DVT组35例和对照组45例。采用SPSS 22.0统计学软件对数据进行统计分析，并用多因素Logistic回归分析脊髓损伤术后的高危因素。
结果：80例脊髓损伤患者术后中有35例发生深静脉血栓，发生率约43.7%。DVT组平均年龄（47.77±10.76）岁高于无DVT组的（37.35±10.20）岁（χ2=19.56，P=0.000）；DVT组体重指数≥ 28 kg/m2，合并糖尿病、吸烟史，无肢体气压治疗及踝泵练习患者的发生率高（P<0.05）；脊髓损伤ASIA分级A级的发生率DVT组（48.5%）高于无DVT组（20%）（P<0.05）。采用MedCalc 15.8软件绘制ROC曲线：当年龄>45岁时，深静脉血栓发生率较高，其特异度：84.4%，敏感性：72.6%。多因素Logistic回归分析结果显示下列因素：患者年龄>45岁[OR=1.665，95% CI（1.102-2.516）]，糖尿病病史[OR=3.273，95% CI（1.291-8.295）]，吸烟史[OR=3.302，95% CI（1.267-8.605）]，脊髓损伤ASIA分级A级[OR=5.736，95% CI（3.152-11.74）]，无肢体气压治疗及踝泵练习[OR=3.013，95% CI（0.116-0.789）]具有统计学意义（P<0.05），是深静脉血栓形成的高危险因素。
结论：脊髓损伤患者术后DVT的发生率仍很高，当年龄>45岁、合并糖尿病病史、吸烟史、脊髓损伤ASIA分级A级等其中一个或多个危险因素时，应提前予以预防措施等对预防深静脉血栓的形成具有重要意义。 |
| 【关键词】脊髓损伤 深静脉血栓 多因素逻辑回归分析 |
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| Analysis of related factors of deep venous thrombosis after spinal cord injury |
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ABSTRACT
Objective: To explore the high-risk factors of deep vein thrombosis (DVT) formation in patients after spinal cord injury (SCI) and to provide some reference value for the prevention of DVT.
Methods: Eighty-five patients with spinal cord injury caused by thoracolumbar burst fracture from January 2016 to December 2017 were selected as subjects. All patients were followed up for 6 months,of which 5 cases were lost and 80 cases were finally included. According to whether there was deep vein thrombosis,the patients were divided into DVT group(35 cases) and control group(45 cases). The clinical data were statistically analyzed by SPSS 22.0 statistical software,and the high-risk factors of spinal cord injury were analyzed by multivariate Logistic regression
Results: Thirty-five of the 80 patients with spinal cord injury developed deep venous thrombosis (incidence rate was about 43.7%). The average age of DVT group[(47.77±10.76) years] was higher than that of non-DVT group[(37.35±10.20) years],and there was a significant difference between two groups(χ2=19.56,P<0.000). Patients with body mass index ≥ 28 kg/m2,combined with diabetes mellitus,smoking history,no limb pressure therapy and ankle pump exercise had a high incidence of DVT. The incidence of ASIA grade A in the spinal cord injury was higher in the DVT group(48.5%) than in the non-DVT group (20%) (P<0.05). The ROC curve was drawn by MedCalc 15.8 software:when the age was more than 45 years old,the incidence of deep venous thrombosis was higher,the specificity was 84.4%,and the sensitivity was 72.6%. Multivariate Logistic regression analysis showed the following factors:patient age >45 years[OR=1.665,95% CI (1.102-2.516)],diabetes history[OR=3.273,95% CI(1.291-8.295)],smoking history[OR=3.302,95% CI(1.267-8.605)],spinal cord injury ASIA grade A[OR=5.736,95% CI(3.152-11.74)],non-limb air pressure therapy and ankle pump exercise[OR=3.013,95% CI(0.116-0.789)] was statistically significant (P<0.05) and was a high risk factor for deep vein thrombosis.
Conclusion: The incidence of DVT is still high in patients with spinal cord injury after surgery. When one or more risk factors such as age >45 years,history of diabetes,smoking history,and ASIA grade A of spinal cord injury is present,preventive measures should be taken in advance,it is of great significance to prevent the formation of deep vein thrombosis. |
| KEY WORDS Spinal cord injury Deep venous thrombosis Multivariate Logistic regression analysis |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 虞鑫,刘伟,张豪伟.脊髓损伤术后深静脉血栓形成的相关因素分析[J].中国骨伤,2020,33(2):140~143 |
| 英文格式: | YU Xin,LIU Wei,ZHANG Hao-wei.Analysis of related factors of deep venous thrombosis after spinal cord injury[J].zhongguo gu shang / China J Orthop Trauma ,2020,33(2):140~143 |
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