四肢骨折术后下肢深静脉血栓发生率及危险因素分析

Analysis on the incidence and risk factors of deep venous thrombosis of lower limbs after fracture

目的研究四肢骨折术后下肢深静脉血栓(DVT)发生率及危险因素。方法选取2017年1月至2020年1月我院收治的行四肢骨折术患者105例作为研究对象,将术后发生DVT患者分为DVT组(30例),术后未发生DVT患者分为非DVT组(85例)。对可能引起DVT的危险因素进行单因素分析和多因素Logistic回归分析。结果 105例四肢骨折患者中,30例术后发生DVT,发生率为28.57%。DVT组年龄≥60岁、有糖尿病、既往血栓史、无踝泵练习占比大于非DVT组,差异具有统计学意义(P<0.05)。多因素Logistic回归分析得出,年龄≥60岁是诱发四肢骨折术后DVT的高危因素(OR=4.428,95%CI:1.545~12.052,P<0.05),踝泵练习为四肢骨折术后DVT的保护因素(OR=0.657,95%CI:0.610~0.783,P<0.05)。结论年龄≥60岁、糖尿病、既往血栓史是诱发四肢骨折术后DVT的危险因素,该类患者在术后应加强监护,踝泵练习是保护因素,应鼓励患者进行早期的踝泵康复练习,预防DVT的发生。

Objective To study the incidence and risk factors of deep venous thrombosis(DVT)of lower extremities after fractures.Methods A total of 105 patients who underwent limb fracture surgery in our hospital from January 2017 to January 2020 were enrolled.The patients with postoperative DVT were used as the DVT group(30 cases),and the patients without postoperative DVT were used Non-DVT group(85 cases).The univariate analysis and multivariate logistic regression analysis were performed on the risk factors that may cause DVT.Results Among the 105 patients with limb fractures,30(28.57%)had postoperative DVT.The number of ≥60 years old,diabetes,previous thrombosis,and no ankle pump exercise was more in DVT group than in non-DVT group(P<0.05).Multivariate logistic regression analysis showed that age ≥60 years was a high-risk factor for DVT after limb fractures(OR=4.428,95%CI:1.545~12.052,P<0.05).Ankle pump exercise was a protective factor for the DVT after limb fractures(OR=0.657,95% CI:0.610~0.783,P<0.05).Conclusion Age ≥60 years,diabetes,and previous thrombosis history are risk factors for DVT after limb fractures.Those patients should be closely monitored after surgery,ankle pump exercise is a protective factor,and patients should be encouraged to perform in early times to prevent the occurrence of DVT.