子宫肌瘤术后并发下肢深静脉血栓的危险因素分析和防治对策

Risk factors of postoperative deep venous thrombosis in lower extremity after uterine fibroids surgery and its prevention and treatment

目的:分析子宫肌瘤术后下肢深静脉血栓形成的危险因素,并提出防治对策。方法:回顾性分析2014年7月～2016年7月义乌市妇幼保健计划生育服务中心278例接受子宫肌瘤手术且病例资料完整的患者,涉及内容有患者的年龄、体重指数(BMI)、职业、吸烟史、术前是否有合并症;术前实验室检查结果是否异常,主要包括D-二聚体、凝血四项和血红蛋白水平等内容;手术时间;麻醉方式;手术后是否接受物理抗凝、术后卧床时间等。对可能影响下肢深静脉血栓的因素进行单因素和多因素分析。结果:278例接受子宫肌瘤手术者术后有25例患者发生下肢深静脉血栓,发生率为8. 99%。多因素logistic回归性分析显示:年龄、BMI、术前合并症、术前实验室检查结果、术后卧床时间、麻醉方式是子宫肌瘤手术患者并发下肢深静脉血栓的独立危险因素(P <0. 05)。结论:子宫肌瘤手术后下肢深静脉血栓发生率较高。针对上述危险因素,积极采取防治对策能够有效地降低下肢深静脉血栓的形成。

Objective ：To analyze the risk factors of deep venous thrombosis （DVT） in lower extremity after uterine fibroids surgery in order to put forward prevention and treatment measures. Methods ：278 patients received uterine fibroids surgery in Yiwu Maternal and Child Health Care Fanfily Planning Service Center from July 2014 to July 2016 were selected and its clinical data was retrospectively analyzed, including age, body mass index （ BMI）, occupation, smoking history, preoperative complications, preoperative laboratory-abnormalities （D-dimer, four items of blood coagulation and hemoglobin content） , operation time, anesthesia, physical anticoagulation after surgery and postoperative bed rest time and etc. Univariate and nmltivariate analyses were performed on the possible risk factors of DVT. Results：There were 25 patients had DVT in lower extremity among the 278 patients, the incidence of 8.99%. Multivariate logistic regression analysis showed that age, BMI, preoperative complication, labora- toryexanfination results, postoperative bed rest time, anesthesia were all independent risk factors of DVT in lower extremity （P 〈 0.05 ）. Conclusions：The incidence of DVT in lower extrenfity is high after uterine fibroids surgery, so prevention and control measures should be taken to effectively reduce the formation of DVT.