下肢深静脉血栓形成的危险因素分析

Risk Factors for Lower Extremity Deep Venous Thrombogenesis

目的研究不同类型下肢深静脉血栓(lower extremity deep venous thrombosis,LDVT)形成的危险因素.方法纳入空军军医大学西京医院2008年1月~2018年10月期间收治的LDVT患者435例,据血栓形成类型的差异,从腹部疾病术后LD-VT、骨科创伤后LDVT、恶性肿瘤术后LDVT、血管疾病治疗后LDVT 4个角度进行亚组分析,探索不同类型LDVT形成的危险因素.结果单因素分析及Logistic多因素回归分析显示下肢水肿(OR=0.202,95%CCI:0.043~0.948,P=0.043)和糖尿病史(OR=12.615,95%CI:2.374~67.039,P=0.003)为腹部疾病术后LDVT的危险因素.麻醉方式(OR=2.260,95%CI:1.086~4.702;P=0.029)为骨科创伤后LDVT的危险因素.手术史(OR=45.778,95%CI:5.308~394.837,P=0.001)为恶性肿瘤术后LDVT的危险因素.血管疾病LDVT主要与抗凝治疗药物服用(OR=5.984,95%CI:1.070~33.468,P=0.042)有关.结论下肢水肿、糖尿病史是腹部疾病术后LDVT的危险因素,麻醉方式、手术史别为骨科创伤后LDVT以及恶性肿瘤术后LDVT的危险因素,抗凝治疗药物服用是血管疾病治疗后LDVT的危险因素.

Objective To explore the risk factors for lower extremity deep venous thrombogenesis(LDVT).Methods Four hundred and thirty-five patients with LDVT,admitted to Xijing Hospital from January 2008 to October 2018,were enrolled into the study.Based on the genesis of LDVT,risk factors of LDVT were conducted from 4 aspects,including LDVT after abdominal operation,LDVT after orthopedic surgery,LDVT after malignant tumor surgery,and LDVT after vascular disease.Results Single factor analysis,together with logistic regression analysis showed lower limb ldema(OR=0.202,95%CI:0.043-0.948,P=0.043)and diabetes history(OR=12.615,95%CI:2.374-67.039,P=0.003)were independent factors for LDVT induced by abdominal operation.Anesthesia method(OR=2.260,95%CI:1.086-4.702,P=0.029)was a risk factor for LDVT after orthopedic surgery.History of operation(OR=45.778,95%CI:5.308-394.837,P=0.001)was significantly related with LDVT after malignant tumor surgery.LDVT after vascular disease was associated with the taking of anticoagulants.Conclusion Lower limb ldema and diabetes history were independent factors for LDVT induced by abdominal operation.Anesthesia method and surgery history were risk factors for LDVT after orthopedic surgery and LDVT after malignant tumor surgery.LDVT after vascular disease was associated with the taking of anticoagulants.