脊柱手术后下肢深静脉血栓的危险因素分析

Risk Factors of DVT in Deep Vein Thrombosis of Lower Extremity after Spinal Surgery

[目的]探讨影响脊柱手术后下肢深静脉血栓（DVT）发生的危险因素。【方法】收集2014年8月至2016年8月在本院行脊柱手术治疗患者246例，根据术后下肢有无DVT发生，将其分为DVT组（45例），非DVT组（201例），比较两组患者临床资料、手术及术后相关因素等，并对脊柱手术后DVT发生的影响因素进行logistics回归分析。【结果】本组病例脊柱手术后DVT发生率为18．29％（45／246）；DVT组与非DVT组患者年龄、体质量指数（BMI）、糖尿病、术前超声结果、术前凝血四项、术中出血量、术中输血、手术时间、术后早期卧床时间、物理抗凝等比较差异均有统计学意义（P〈0．05）；多因素Logistic回归分析显示：年龄、术前超声、术前凝血功能、术中输血、术后早期卧床时间、物理抗凝是脊柱手术后DVT发生的独立危险因素。【结论】高龄、术前超声异常、术前凝血四项异常（≥2）、术中输血、术后早期卧床时间≥5d是脊柱手术后患者并发DVT的独立危险因素，而早期下床活动、物理抗凝是脊柱手术后DVT发生的保护因素。

[Objective] To investigate the risk factors of DVT in deep vein thromboszs ot lower extremity after spinal surgery.[Methods] From August 2014 to August 2016, 246 patients were collected in our hospital for spinal surgery. According to the occurrence of DVT in the lower extremities after operation, the patients were divided into DVT group （ n =45） and non-DVT group （ n =201）. The clinical data, surgical and post operative factors were compared between the two groups. The influencing factors of DVT after spinal surgery were analyzed by logistics regression analysis.[Results]The incidence of DVT after spinal surgery in this group was 18.29% （45/246）. In the comparison of age, body mass index （BMI）, diabetes mellitus, preoperative ul- independent risk factors of DVT patients after spinal surgery, while early bed activity , physical anticoagula tion are protective factors for DVT following spinal surgery.