颅脑肿瘤患者术后下肢深静脉血栓的危险因素分析

Analysis of risk factors for postoperative deep venous thrombosis of patients with brain tumors

目的探讨颅脑肿瘤患者术后发生下肢深静脉血栓(deep venous thrombosis,DVT)的高危因素。方法选取2017年1月至2019年5月首都医科大学附属北京天坛医院颅脑肿瘤术后入住重症监护室(intensive care unit,ICU)的患者230例,收集临床资料,采用双下肢彩色多普勒超声检查诊断是否发生DVT,logistic回归法分析DVT发生的高危因素。结果230例患者,85例术后发生DVT,发生率为36.96%。其中20例(23.53%)发生于术后3 d内,53例(62.35%)发生于术后4~7 d,12例(14.12%)发生于术后7 d以后,DVT发生的中位时间为术后7(4,7)d。女性(OR=3.251,P=0.005)、高脂血症(OR=4.795,P=0.019)、幕上肿瘤(OR=3.114,P=0.000)、术中输血(OR=2.256,P=0.003)、肢体肿胀(OR=9.356,P=0.000)是颅脑肿瘤术后DVT发生的危险因素。结论颅脑肿瘤患者术后DVT发生率较高。多数患者DVT于术后7 d内发生,术后早期行下肢彩色多普勒超声十分必要。

Objective To investigate the incidence and high risk factors of postoperative deep venous thrombosis(DVT)in the patients with brain tumors.Methods The patients with brain tumors in ICU of Beijing Tiantan Hospital were selected.The general data and clinical data of subjects were collected.Color Doppler ultrasonography was used to diagnose DVT.Logistic regression analysis was used to analyze risk factors.Results A total of 230 patients with brain tumors were observed.The incidence of DVT was 36.96%.Twenty patients(23.53%)developed DVT in the hyperacute phase(≤3 d)and 53 patients(62.35%)developed in the acute phase(4-7 d),12 patients(14.12%)developed after 7 d.Logistic regression analysis showed that female(OR=3.251,P=0.005),hyperlipidemia(OR=4.795,P=0.019),supratentorial brain tumor(OR=3.114,P=0.000),intraoperative blood transfusion(OR=2.256,P=0.003),and limb swelling(OR=9.356,P=0.000)were the risk factors of DVT in postoperative patients with brain tumors.Conclusions The incidence of DVT after operation in the patients with brain tumor is high.Most DVT occurrs in seven days after operation,color Doppler ultrasonography is necessary for diagnosis during the early postoperative phase.