高海拔地区深静脉血栓发生情况及危险因素分析

目的调查高海拔地区非长期卧床患者深静脉血栓(DVT)发生情况及危险因素。方法选取2018年9月至2019年5月于日喀则市人民医院住院且于入院2天内行四肢血管B超检查的DVT患者67例,另选取87例健康者作为对照。回顾性分析DVT患者的四肢血管B超筛查结果,收集并比较两组的性别、年龄、血常规、凝血功能、D-二聚体等指标资料。结果与对照组比较,DVT组的D-二聚体及纤维蛋白降解产物浓度明显升高,差异有统计学意义(P<0.05)。多因素Logistic回归分析提示,年龄(P=0.005)和纤维蛋白原(P=0.024)是DVT发生的高危因素。按性别对DVT组进行亚组分析发现,男性DVT患者的血红蛋白浓度和红细胞压积均高于女性DVT患者,差异有统计学意义(P<0.05)。结论日喀则地区四肢DVT的发生与红细胞增多无明显相关,D-二聚体及FDP升高对DVT形成具有预警意义,年龄、纤维蛋白原水平是DVT发生的高危因素。

Objective To investigate the occurrence and risk factors of deep vein thrombosis(DVT)in non-long-term bedridden patients in high altitude areas.Methods A total of 67 patients with DVT who were hospitalized in Xigaze People's Hospital from September 2018 to May 2019 and underwent extremity vascular B-ultrasound examination within 2 days of admission were selected,and 87 healthy patients were selected as controls.The results of B-ultrasound screening of blood vessels in extremities of patients with DVT were retrospectively analyzed,and the gender,age,blood routine,coagulation function,D-dimer and other indicators of the two groups were collected and compared.Results Compared with the control group,the concentration of D-dimer and fibrin degradation products in the DVT group were significantly increased,and the differences were statistically significant(P<0.05).Multivariate logistic regression analysis indicated that age(P=0.005)and fibrinogen(P=0.024)were high risk factors for DVT.A subgroup analysis of the DVT group by gender revealed that the hemoglobin concentration and hematocrit of male DVT patients were higher than those of female DVT patients,and the differences were statistically significant(P<0.05).Conclusion The occurrence of DVT in the extremities in Xigaze is not significantly related to the increase of red blood cells.The increase of D-dimer and FDP has early warning significance for the formation of DVT.Age and fibrinogen level are high risk factors for DVT.