中老年人腰椎退变性疾病术后早期下肢深静脉血栓形成的相关因素

Related factors of early postoperative lower extremity deep venous thrombosis in middle-aged and elderly patients with lumbar degenerative diseases

目的:探讨中老年人腰椎退变性疾病术后早期并发深静脉血栓形成(DVT)的相关因素。方法:腰椎退变性疾病手术患者200例,术前均经双下肢血管彩色多普勒超声显像检查确认均无血栓形成,术后第4、8、12天分别行下肢多普勒超声检查。术后有DVT形成39例(DVT组),无DVT形成161例(非DVT组),比较两组患者的性别、年龄、BMI、合并高血压和糖尿病情况以及手术时间、术中出血量、D-二聚体等。Logistic回归分析DVT的危险因素。结果:200例患者中发生DVT者39例,发生率为19. 5%。两组患者年龄、手术时间、术中出血量的差异有统计学意义(P <0. 05)。Logistic回归分析结果显示D-二聚体(OR=3. 343,95%CI=1. 308～8. 541)、糖尿病(OR=3. 928,95%CI=1. 090～14. 156)和年龄(OR=4. 898,95%CI=1. 807～13. 278)是术后早期并发下肢DVT的危险因素。结论:年龄≥66岁的患者更易发生下肢DVT,D-二聚体和有糖尿病是下肢DVT的相关因素。

Aim:To investigate the related factors of early postoperative deep venous thrombosis(DVT)in middle-aged and elderly patients with lumbar degenerative diseases.Methods:A total of 200 patients who underwent lumbar surgery and were confirmed no thrombosis by preoperative examination accepted lower extremity Doppler ultrasonography on the 4th,8th and 12th day after surgery.There were 39 patients developed DVT after sugery(DVT group).The gender and age distribution as well as BMI,complications such as hypertension and diabetes,duration of surgery,amount of bleeding during surgery and D-dimer level between DVT group and non-DVT group were compared.Logistic regression was used to analyze the related factors of early DVT.Results:The incidence of DVT was 19.5%(39/200).There were significant differences in age,duration of surgery,and intraoperative blood loss between the 2 groups(P<0.05).Logistic regression analysis showed that D-dimer(OR=3.343,95%CI=1.308-8.541),diabetes(OR=3.928,95%CI=1.090-14.156),and age(OR=4.898,95%CI=1.807-13.278)were risk factors for early postoperative DVT.Conclusion:Patients over the age of 66 years are more likely to develop lower extremity DVT.D-dimer and diabetes are related factors for lower extremity DVT.