骨创伤患者并发静脉血栓栓塞症的影响因素分析

Analysis of the Influence Factors in Venous Thromboembolism of Orthopaedic Trauma Patients

目的探讨烟威地区骨创伤患者并发静脉血栓栓塞症的影响因素。方法取山东省文登整骨医院2012年1月至2016年12月骨科收治的31 652例骨创伤住院患者作为研究对象(烟威地区),采用彩色多普勒超声或静脉造影进行检查,最终确诊1 424例并发静脉血栓栓塞症患者。回顾性分析入组患者基本资料,包括性别、年龄、既往病史、吸烟史、骨创伤部位、深静脉血栓(deep venous thrombosis,DVT)好发部位、伴随疾病等进行单因素和多因素Logistic回归分析,分析骨创伤患者并发静脉血栓栓塞症的影响因素。结果 31 652例骨创伤住院患者中,1 424例确诊为并发静脉血栓栓塞症,发生率为4.50%。其中,DVT 1 304例,发生率为4.12%,肺栓塞(pulmonary embolism,PE)237例,发生率为0.74%。单因素及多因素Logistic分析结果显示:骨创伤患者并发静脉血栓栓塞症发生率与年龄、是否需要长期制动、骨创伤部位、糖尿病、D-二聚体水平、简明损伤分级(abbreviated injury scale,AIS)及创伤严重程度评分(injury severity scale,ISS)具有统计学意义(P<0.05)。结论骨创伤患者并发静脉血栓栓塞症发生率与年龄、是否需要长期制动、骨创伤部位、糖尿病及D-二聚体水平、AIS分级及ISS评分关系密切。

Objective To investigate the influencing factors of venous thromboembolism in patients with bone trauma.Methods A total of 31 652 patients with bone trauma admitted to the Department of Orthopaedics of Wendeng Osteopathic Hospital from January 2012 to December 2016 were enrolled in the study(Smoky area).Color Doppler ultrasound or venography was used to examine 1 424 cases with venous thromboembolism.Retrospective analysis of the basic data of the patients included gender,age,past medical history,smoking history,bone trauma site,DVT predilection sites and associated diseases were performed with univariate and multivariate logistic regression analysis to analyze the influencing factors.Results Of the 31 652 hospitalized patients with bone trauma,1 424 were diagnosed with complicated venous thromboembolis with an incidence of 4.50%.Among them,there were 1304 cases of DVT,and the incidence rate was 4.12%.There were 237 cases of PE,and the incidence rate was 0.74%.Univariate and multivariate logistic analysis showed that the incidence of venous thromboembolism in patients with bone trauma was asociate with age,long-term immobilization,bone trauma sites,diabetes,D-dimer levels,AIS,and ISS(P<0.05).Conclusion The incidence of venous thromboembolism in patients with bone trauma is closely related to age,need for long-term immobilization,bone trauma,diabetes and D-dimer levels.