烧伤患者深静脉血栓易发因素的研究

Risk factors of deep venous thrombosis in burn patients

目的探讨烧伤患者并发深静脉血栓(DVT)易发因素。方法收集近3年烧伤合并DVT的患者为观察组,选取同期未发生DVT患者为对照组,检测两组患者血小板计数、D-二聚体、红细胞压积、凝血酶原时间、纤维蛋白原、全血粘度、P选择素及抗心磷脂抗体,分析数据。统计患者的性别、年龄、体重、烧伤面积;三度烧伤面积;D-二聚体;伤后卧床时间;深静脉置管次数;深静脉置管天数,对数据进行Logistic回归分析。结果16名并发DVT患者为观察组,对照组的16名患者的年龄、性别、烧伤面积与观察组相比差异无统计学意义(P>0.05)。观察组与对照组血小板计数比较:(525.1±144.8)比(402.6±144.6),P<0.05;观察组与对照组D-2聚体比较:(1.71±0.83)比(0.95±0.55),P<0.01;观察组P选择素含量与对照组比较:(389.1±68.3)比(294.3±61.5),P<0.01,差异有统计学意义。1126名患者Logistic回归分析结果显示D-二聚体(B=1.725,OR=5.612,P<0.05)为烧伤患者发生DVT的危险因素。结论血小板和P选择素异常增高可能是血栓前状态的重要指标,D-二聚体是烧伤患者并发DVT的独立危险因素。

Objective To investigate the risk factors of deep vein thrombosis(DVT)in burn patients.Methods The burn patients with DVT in recent 3 years were collected as the observation group,and the patients without DVT in the same period were selected as the control group.The platelet count,D-dimer,hematocrit,prothrombin time,fibrinogen,whole blood viscosity,P-selectin and anticardiolipin antibody were detected and analyzed.The data of gender,age,body weight,burn area,third degree burn area,D-dimer;bed time after injury,times of deep vein catheterization,and days of deep vein catheterization were collected and analyzed by logistic regression.Results There were no significant differences in age,gender and burn area between the control group and the observation group(P>0.05).Compared with the control group,the platelet count of the observation group was(525.1±144.8)vs.(402.6±144.6),P<0.05;the D-dimer of the observation group and the control group was(1.71±0.83)vs.(0.95±0.55),P<0.01;the P-selectin content in the observation group was(389.1±68.3)vs.(294.3±61.5),P<0.01,with statistical significance.Logistic regression analysis showed that D-dimer(B=1.725,OR=5.612,P<0.05)may be a risk factor for DVT in burn patients.Conclusions Abnormal increase of platelets and P-selectin may be important indicators of prethrombotic state.D-dimer is an independent risk factor for DVT in burn patients.