脊柱创伤患者术后深静脉血栓发生及危险因素分析

Occurrence and risk factors of deep vein thrombosis among spinal trauma patients after operation

目的了解脊柱创伤患者术后深静脉血栓发生情况及其危险因素,为临床骨科预防术后深静脉血栓提供参考依据。方法随机抽取江苏省苏州大学附属第一医院2012年3月—2015年3月收治的150例脊柱创伤手术患者病历资料,并对患者在术后半年进行下肢静脉血管彩色超声检查。结果 150例脊柱创伤患者中,术后发生深静脉血栓者60例,深静脉血栓发生率为40.00%;多因素非条件logistic回归分析结果显示,年龄≥60岁、有≥2项凝血指标异常、手术时间≥3.0 h、术中失血量≥800 m L、术中进行输血和术后卧床时间≥5 d是脊柱创伤患者术后深静脉血栓发生的危险因素。结论脊柱创伤患者术后深静脉血栓发生率较高,年龄较大、有多项凝血指标异常、手术时间较长、术中失血量较多、术中进行输血和术后卧床时间较长的脊柱创伤患者术后更易发生深静脉血栓。

Objective To examine the incidence and influencing factors of deep vein thrombosis （DVT） among patients with spinal trauma after operation, and to provide references for preventing DVT in patients after orthopedics surgery. Methods Totally 150 patients with spinal trauma surgery were selected randomly in First Affiliated Hospital of Suzhou University from March 2012 to March 2015 ;medical records of the patients were collected and color Doppler ultrasound examination of lower extremity venous blood vessels was carried out 6 months after the surgery. Results Among all the patients,60 were identified with post-operation DVT, with an DVT incidence of 40. 00%. Multivariate non-conditional logistic regression analysis showed that aged ≥ 60 years, with the history of two or more abnormal coagulation indexes, experiencing the operation duration of 3 hours or more, having intraoperative hemorrhage volume of 800 milliliters or more, having intraoperative blood transfusion, and having postoperative bed time of 5 days or more were risk factors of DVT incidence. Conclusion The incidence of post-operation DVT is higher among patients with spinal trauma and the patients at older age, with more items of abnormal coagulation index, having longer operation time, with more intraoperative blood loss, having intraoperative blood transfusion, and having more postoperative bed days are more likely to have DVT.