心血管植入式电子装置导线相关静脉血栓形成的危险因素分析:112例报告

Risk factors for venous thrombosis related to the lead of cardiovascular implantable electronic device:an analysis of 112 cases

目的研究心血管植入式电子装置(CIED)导线相关静脉血栓形成的相关危险因素,为临床预防提供理论依据。方法选取2013年9月至2015年12月解放军总医院心血管内科使用CIED且随访资料完整的住院患者112例,根据术后血管超声检查结果进行分组,血栓组56例,年龄(71.86±8.35)岁;非血栓组56例,年龄(71.23±10.62)岁,运用多因素logistic回归分析对CIED导线相关静脉血栓形成的危险因素进行分析。结果两组房颤患者数、植入除颤导线患者数、服用抗凝药物患者数和左室射血分数、全血糖化血红蛋白水平以及手术中静脉穿刺次数、手术时间、导线数量相比较,差异均有统计学意义(P<0.05)。多因素logistic回归分析表明,房颤、术中静脉穿刺次数、手术时间及导线数量是CIED导线相关静脉血栓形成的危险因素,服用抗凝药物是保护因素。结论房颤、静脉穿刺次数、手术时间及导线数量是CIED导线相关静脉血栓形成的独立危险因素。

Objective To analyze the risk factors for venous thrombosis related to the lead of cardiovascular implantable electronic device （CIED） in order to provide the theoretical basis for clinical prevention.Methods A total of 112 patients undergoing CIED implantation and with full follow-up data who hospitalized in our department from September 2013 to December 2015 were recruited in this study.According to the results of postoperative vascular ultrasound examination, they were assigned to the thrombosis group [n=56, at an age of （71.86±8.35） years] and the non-thrombosis group [n=56, at an age of （71.23±10.62） years].Their clinical data were collected and retrospectively analyzed.Multivariate logistic regression analysis was applied to assess the risk factors of the related venous thrombosis.Results There were significant differences in the numbers of patients with atrial fibrillation, those with implanted defibrillator leads and those taking anticoagulant medications, the left ventricular ejection fraction, the serum level of glycosylated hemoglobin, as well as the times of venipuncture, operation time, and lead numbers between the thrombosis and the non-thrombosis groups （P〈0.05）.Multivariate logistic regression analysis showed atrial fibrillation, times of venipuncture, operation time and lead numbers were the risk factors for the related venous thrombosis, and administration of anticoagulant medications was the protective factor.Conclusion Atrial fibrillation, times of venipuncture, operation time and lead numbers are the independent risk factors for venous thrombosis related to CIED leads.