子宫切除术后患者下肢深静脉血栓形成的相关因素分析

Analysis on the Related Factors of 56 Patients with Lower Deep Venous Thrombosis after Hysterectomy

【目的】探讨子宫切除术后患者下肢深静脉血栓形成（DVT）的相关因素。【方法】选择在本院妇产科行全子宫切除且术后出现DVT的56例患者作为观察组，同期行全子宫切除且术后未出现下肢DVT的258例患者作为对照组，对两组患者的临床资料和实验室检查指标进行回顾性对比分析。【结果】观察组平均年龄、有过手术史及输血史的比例均显著高于对照组，心血管疾病患病率及抗血小板药物、抗凝药物、活血化瘀药物的使用率均显著低于对照组，且组间比较差异有显著性（Pd0．05）。观察组纤维蛋白原（Fib）显著高于对照组；凝血酶原时间（PT）显著低于对照组，且组间比较差异有显著性（P〈0．05）。多因素Logistic回归分析显示：高Fib血症和年龄较大是子宫切除术后下肢发生DVT的独立危险因素，而使用抗血小板药物、抗凝药物以及活血化瘀药物是其保护因素。【结论】子宫切除术后DVT发生与多种因素有关。针对高危人群临床上应进行早期预防、及时诊治及精心护理可减少DVT的发生。

[Objective] To explore the related factors of 56 patients with lower extremity deep venous thrombosis（DVT） after hysterectomy. [Methods] A total of 56 patients with DVT after hysterectomy in obstetrics and gynecology department of our hospital were taken as observation group, and 258 homeochronous patients without DVT after hysterectomy were taken as control group. Clinical data and laboratory examination indexes of two groups were analyzed retrospectively. [Results] The average age, operation history and blood transfusion history in observation group were markedly higher than those in control group, while the preva- lence of cardiovascular disease, the use rate of antiplatelet drugs, anticoagulants, promoting blood circulation and removing blood stasis drugs in observation group were markedly lower than those in control group, and there were significant differences between groups（ P 〈0.05）. The fibrinogen（Fib） in observation group was markedly higher than that in control group, while prothrombin time（PT） in observation group was markedly lower than that in control group, and there were significant differences between groups（ P 〈0.05）. Multivari- ate logistic regression analysis showed that hyperfibrinogenemia and older age were independent risk factors of lower extremity DVT after hysterectomy, while the use of antiplatelet drugs, anticoagulants and promoting blood circulation and removing blood stasis drugs were the protective factors. [Conclusion] The occurrence of I）VT in patients after hysterectomy is related to multiple factors. For high-risk patients, early prophylaxis, prompt diagnosis and treatment and careful nursing can reduce the incidence of DVT.