股骨粗隆间骨折患者伴有高血压、糖尿病对围术期下肢深静脉血栓的影响

Effects of hypertension and diabetes mellitus on perioperative deep vein thrombosis of lower extremity in patients with femoral intertrochanteric fracture

目的:分析股骨粗隆间骨折患者伴有高血压、糖尿病对围术期下肢深静脉血栓的影响。方法:选取我院2020年1月至2021年10月期间收治的113例股骨粗隆间骨折患者,按患者合并症的不同分为四组,即A组高血压组(n=27),B组糖尿病组(n=14),C组高血压、糖尿病组(n=6),D组非高血压、糖尿病组(n=66);比较四组围术期下肢深静脉血栓发生率,评估四组患者凝血指标。结果:C组下肢深静脉血栓发生率33.33%明显高于A组、B组、D组,差异有统计学意义(P<0.05),其余三组比较,差异无统计学意义(P>0.05)。C组术前、术后D-二聚体、纤维蛋白原、VEGF、TXB2水平高于A组、B组、D组,血红蛋白、红细胞压积水平均低于A组、B组、D组(P<0.05),且A、B两组与D组比较也存在显著差异(P<0.05)。结论:股骨粗隆间骨折患者伴有高血压、糖尿病,会增加围术期下肢深静脉血栓发生率,加剧机体高凝状态,临床意义高。

Objective:To analyze the effect of hypertension and diabetes mellitus on perioperative deep vein thrombosis of lower extremity in patients with femoral intertrochanteric fracture.Methods:A total of 113 patients with femoral intertrochanteric fractures admitted to our hospital from January 2020 to October 2021 were selected and divided into four groups according to the different comorbidities of the patients,namely group A with hypertension(n=27),group B diabetes group(n=14),group C with hypertension and diabetes(n=6),group D without hypertension and diabetes(n=66);The incidence of perioperative deep venous thrombosis of lower limbs in the four groups was compared,and the coagulation indexes of the four groups were evaluated.Results:The incidence of lower extremity deep vein thrombosis in group C was 33.33%,which was significantly higher than that in groups A,B,and D,and the difference was statistically significant(P<0.05).The levels of D-dimer,fibrinogen,VEGF,and TXB2 in group C before and after operation were higher than those in groups A,B,and D,and the levels of hemoglobin and hematocrit were lower than those in groups A,B,and D(P<0.05),at the same time,there was also a significant difference between the A and B groups and the D group(P<0.05).Conclusion:Patients with femoral intertrochanteric fracture accompanied by hypertension and diabetes will increase the incidence of deep vein thrombosis in the lower extremity during the perioperative period,aggravate the hypercoagulable state of the body,and have high clinical significance.