影响妇科腹腔镜术后下肢深静脉血栓形成的相关因素分析

Analysis on the Gynecologic Laparoscopic Surgery Related Factors of Lower Extremity Deep Vein Thrombosis

目的:探讨妇科腹腔镜手术后下肢深静脉血栓形成(DVT)的危险因素。方法:回顾性分析339例行妇科腹腔镜手术患者的临床资料,对患者的一般临床资料、术前实验室检查指标、手术类型、术中治疗及术后干预措施等进行单因素及多因素Logistic回归分析。结果:339例行妇科腹腔镜手术患者中30例术后发生DVT(发生率约8.8%),年龄(OR=1.438)、手术类型(腹腔镜妇科恶性肿瘤手术)(OR=3.153、血浆D-二聚体水平≥0.5 mg/L(OR=2.531)、术前合并症(OR=2.885)、术中气腹压(OR=2.835)、手术时间≥1h(OR=1.397)、术后卧床天数(OR=1.498)与妇科腹腔镜手术后发生DVT呈正相关(P<0.05)。结论:年龄、手术类型、血浆D-二聚体水平、术前合并症、术中气腹压、手术时间及术后卧床天数是妇科腹腔镜术后发生VDT的独立危险因素。

Objective： To explore the risk factors of lower extremity deep venous thrombosis（DVT） after gynecologic laparoscopic surgery.Methods： A retrospective analysis was carried on the clinical data of 339 patients who underwent gynecologic laparoscopic surgery.The single factor and multiple factors Logistic regression analysis were applied to the general clinical data of patients,preoperative laboratory examination index,types of operation,intraoperative and postoperative intervention treatment.Results： Among the 339 patients who underwent gynecologic laparoscopic surgery,30 cases had postoperative DVT（incidence about 8.8%）.Such factors were positively correlated DVT as age（OR=1.438）,type of surgery（laparoscopic gynecologic malignant tumor surgery）（OR=3.153）,plasma D-dimer level ≥0.5 mg/L（OR=2.531）,preoperative complications（OR=2.885）,intraoperative pneumoperitoneum pressure（OR=2.835）,the operation time ≥1 h（OR=1.397） and days in bed after gynecological laparoscopic surgery（OR=1.498）（P〈0.05）.Conclusion： Age,type of operation,the plasma D-dimer level,preoperative complications,intraoperative pneumoperitoneum pressure,operation time and postoperative days in bed were independent risk factors for the development of VDT after gynecologic laparoscopic surgery.