骨盆骨折深静脉血栓形成影响因素分析

Analysis of influencing factors of deep vein thrombosis in pelvic fracture

目的深静脉血栓形成(DVT)是骨科患者常见并发症,也是导致肺栓塞的主要原因。本研究分析骨盆骨折DVT形成的影响因素。方法选择沈阳市骨科医院2014-01-01-2018-12-31收治的120例骨盆骨折患者为研究对象,其中DVT组28例,非DVT组92例。采用单因素及Logistics分析骨盆骨折患者DVT发生的高危因素。结果年龄(χ2=6.152,P=0.013)、手术时间(χ2=9.005,P=0.003)、输血(χ2=6.213,P=0.013)、术前D-二聚体>500ng/mL(χ2=49.413,P<0.001)、术后D-二聚体>500ng/mL(χ2=37.362,P<0.001)、卧床时间≥72h(χ2=5.256,P=0.022)和血糖≥7.8mmol/L(χ2=6.716,P=0.010)与骨盆骨折患者发生DVT有关联。年龄(OR=1.076,95%CI为1.030~1.123,P=0.001)、手术时间(OR=1.005,95%CI为1.001~1.009,P=0.017)、输血(OR=7.815,95%CI为1.629~37.487,P=0.010)、术后D-二聚体>500ng/mL(OR=13.777,95%CI为2.872~66.089,P=0.001)、卧床时间≥72h(OR=4.263,95%CI为1.679~10.710,P=0.002)和血糖≥7.8mmol/L(OR=4.609,95%CI为1.663~12.771,P=0.003)是骨盆骨折患者发生DVT的危险因素。结论高龄、手术时间长、输血、术后D-二聚体升高、卧床时间长和血糖高是骨盆骨折DVT形成的影响因素。

Objective Deep vein thrombosis(DVT)is a common complication in orthopedic patients and the main cause of pulmonary embolism.This study analyzed the factors affecting the formation of DVT in pelvic fractures.Methods The patients with pelvic fracture(120 cases)admitted to Shenyang Orthopedic Hospital from January 1,2014 to December 31,2018 were selected as the research objects,including 28 cases in the DVT group and 92 cases in the non-DVT group.Single factor and logistics were used to analyze the high-risk factors of DVT in patients with pelvic fracture.Results Age(χ2=6.152,P=0.013),operation time(χ2=9.005,P=0.003),blood transfusion(χ2=6.213,P=0.013),preoperative D-dimer>500 ng/ml(χ2=49.413,P<0.001),postoperative D-dimer>500 ng/ml(χ2=37.362,P<0.001),bed time≥72 h(χ2=5.256,P=0.022),blood glucose≥7.8 mmol/L(χ2=6.716,P=0.010)were associated with DVT in patients with pelvic fracture.Age(OR=1.076,95%CI:1.030-1.123,P=0.001),operation time(OR=1.005,95%CI:1.001-1.009,P=0.017),blood transfusion(OR=7.815,95%CI:1.629-37.487,P=0.010),postoperative D-dimer>500 ng/ml(OR=13.777,95%CI:2.872-66.089,P=0.001),bed time≥72 h(OR=4.263,95%CI:1.679-10.710,P=0.002)and blood glucose≥7.8 mmol/L(OR=4.609,95%CI:1.663-12.771,P=0.003)were risk factors for DVT in patients with pelvic fractures.Conclusion Old age,long operation time,blood transfusion,postoperative increase of D-dimer,long time in bed and high blood sugar are the influencing factors of the formation of pelvic fracture DVT.