ICU重症患者并发静脉血栓栓塞风险和预防措施探讨

Analysis of the risk factors and prevention of venous thromboembolism for severe patients in ICU

目的探讨ICU重症患者并发静脉血栓栓塞的风险及预防措施。方法回顾性分析本院ICU2011年8月至2014年6月收治的613例重症患者的诊治资料,根据患者入住ICU期间是否并发静脉血栓分为血栓组(128例)和非血栓组(485例),比较两组患者一般资料、疾病情况,并对血栓组患者入住ICU第一日Caprini评分与相关指标进行相关性分析。结果血栓组患者年龄、急性生理功能与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分显著高于非血栓组,格拉斯哥昏迷评分(GCS)显著低于非血栓组(P<0.05);血栓组外科疾病患者所占比例高于非血栓组(P<0.05)。外科疾病患者入住ICU第一日Caprini评分显著高于内科疾病患者(P<0.001);男性患者Caprini评分低于女性患者(P>0.05)。血栓组患者Caprini评分与APACHEⅡ评分、年龄呈显著正相关(P<0.05),与GCS评分无相关性(P>0.05)。血栓组患者采取预防措施的比例显著高于非血栓组(P<0.05)。结论ICU重症患者并发静脉血栓栓塞与年龄、APACHEⅡ评分呈正相关,及时采取预防措施可有效降低并发静脉血栓的风险。

Objective To investigate the risk factors and prevention of venous thromboembolism for severe patients in ICU. Method Retrospective analyzed of the clinical data of 613 cases of severe patients admitted to our hospital from August 2011 to June 2014, according to the patients during the ICU stay whether complicated by venous thrombosis, they were divided into thrombus group （128 cases） and non thrombus group （485 cases）. Compared two groups of patients with general information, disease conditions, and the thrombus group patients admitted to ICU on the first day of the Caprini score and the related indexes by correlation were analyzed. Result The age, APACHE I[ score of patients in thrombus group were significantly higher than non thrombus group, the GCS score was significantly lower than non thrombus group （P 〈 0.05）. The proportion of patients with surgical disease in thrombus group was higher than non thrombus group （P 〈 0.05）. Surgical disease patients admitted to the ICU the first days Caprini score was significantly higher than internal medicine patients （P 〈 0.001）. The Caprini score of male patients was lower than female patients （P 〉 0.05）. Thrombus group patients Caprini score and APACHE II score, age had significant positive correlation （P 〈 0.05）, and no correlation between GCS score （P 〉 0.05）. The ratio of preventive measures in thrombus group was significantly higher than non thrombus group （P 〈 0.05）. Conclusion Severe patients in ICU complicated with venous thromboembolism are positively correlated with age, APACHE II score, take timely preventive measures can effectively reduce the risk of concurrent venous thromboembolism.