下肢骨折并发深静脉血栓形成的相关因素分析与护理

Nursing and Correlated Factors Analysis of Lower Extremity Fracture Complicated with Deep Venous Thrombosis

目的分析下肢骨折术后并发深静脉血栓形成的相关因素，并总结其护理方法。方法将2012年6月-2017年6月德阳市人民医院骨科收治的下肢骨折234例患者作为研究对象，根据术后是否并发下肢深静脉血栓分为血栓组44例和正常组190例。比较两组患者性别、年龄、体质量指数、损伤原因、外伤至住院时间、住院至手术时间、合并疾病、术前是否抗凝治疗、手术时间、术后主被动锻炼及卧床时间等方面资料。结果血栓组和正常组在患者年龄、合并伤、高血压、高脂血症、外伤至住院时间、住院至手术时间、术前抗凝治疗、手术时间、术后主被动锻炼及卧床时间等方面差异均有统计学意义（P〈0．05）；多因素logistic回归分析结果显示，术前未抗凝治疗、手术时间〉2h、术后未进行主被动锻炼为下肢骨折术后并发深静脉血栓形成的危险因素。结论下肢骨折患者术前应综合评估高危因素，预防性抗凝，术中尽量缩短手术时间，术后指导患者尽早下床活动，加强主被动功能锻炼，以预防深静脉血栓形成的发生。

Objective To analyze the correlated factors thrombosis and summarize the nursing methods. Methods of lower extremity fracture complicated with deep venous A total of 234 patients with lower extremity fracture were selected in Orthopaedics Department, Deyang People＇s Hospital from June, 2012 to June, 2017. According to deep venous thrombosis occurrence, all patients were divided into deep venous thrombosis group （n=44） and normal group （n=190）. The gender, age, BMI, injury reason, the time from trauma to hospitalization, the time from hospitalization to operation, complication, preoperative anticoagulant therapy, operation time, postoperative active or passive exercise, and in-bed time were compared and analyzed. Results There were significant differences in patient age, complicated injuries, hypertension, hyperlipemia, time from trauma to hospitalization, time from hospitalization to operation, preoperative anticoagulant therapy, operation time, postoperative active or passive exercise, and in-bed time between two groups （P〈0.05）. Multivariate logistic regression analysis indicated that no anticoagulant therapy, operation time 〉2 hours, no postoperative active or passive exercise were risk factors in lower extremity fracture complicated with deep venous thrombosis. Conclusion In order to prevent deep venous thrombosis, the patients with lower extremity fracture should comprehensively evaluate high risk factors before operation, take prophylactic anticoagulant therapy, shorten operation time, and strengthen postoperative active or passive exercise.