胸腰段脊柱骨折伴脊髓损伤术后下肢深静脉血栓形成的临床分析

Clinical analysis of lower limb deep venous thrombosis after thoracolumbar spine fracture with spinal cord injury

目的:回顾性分析胸腰段脊柱骨折伴脊髓损伤患者下肢深静脉血栓(DVT)发生率及独立危险因素。方法:以2016年1月至2017年12月本院连续收治的脊髓损伤患者为对象,选取其中胸腰段脊柱骨折作为研究目标,收集临床资料、下肢静脉彩超、实验室检查等资料,统计分析DVT发生率及独立危险因素,以下肢静脉彩超诊断DVT,怀疑肺栓塞者行胸部CTA。结果:共纳入胸腰段脊柱骨折伴脊髓损伤患者160例,有下肢DVT形成31例(19. 4%),肺栓塞1例(0. 6%)。分析显示,D-二聚体升高、高龄、肥胖、完全性脊髓损伤和合并糖尿病是本人群下肢DVT形成的独立危险因素。结论:胸腰段脊柱骨折伴脊髓损伤患者下肢DVT形成的发生率较高。D-二聚体升高、高龄、肥胖、完全性脊髓损伤和患有糖尿病是本人群下肢DVT形成的独立危险因素。

Objective:To retrospectively analyze the incidence and related factors of deep venous thrombosis(DVT)in patients with thoracolumbar spine fracture and spinal cord injury.Methods:Patients from January,2016 to December,2017 in our hospital were included and patients with spinal cord injury,result from thoracolumbar fracture were analyzed.Collecting clinical information,lower limb vein colour to exceed,laboratory examination for statistical analysis of the risk factor for the formation of DVT,DVT was diagnosed by lower limb venous color doppler ultrasonography,patients with suspected pulmonary embolism were treated with chest CTA.Results:A total of 160 patients with thoracolumbar fracture and spinal cord injury were included,including 31cases with DVT(19.4%)of lower limbs,1 case with PE(0.6%.Logistic regression analysis showed that increased D-dimer,advanced age,obesity,complete spinal cord injury and diabetes were independent related factors for DVT.Conclusion:The incidence of lower limb DVT formation is higher in patients with thoracolumbar spine fracture and spinal cord injury.Elevated D-dimer,advanced age,obesity,complete spinal cord injury and diabetes are independent risk factors for DVT formation in the lower limb of this population.