高血压合并下肢创伤性骨折患者术后深静脉血栓形成与术中血压变异性的相关性分析

目的探索高血压合并下肢创伤性骨折患者术后深静脉血栓形成(DVT)与术中血压变异性(IBPV)的相关性。方法收集2019年1月至2021年12月高血压合并下肢创伤性骨折并行手术治疗的患者196例,根据术后是否发生深静脉血栓分为DVT组49例和无DVT组147例,比较两组临床资料,分析术后DVT与IBPV的相关性。结果与无DVT组,DVT组年龄、BMI、全身麻醉比例、术中出血量、手术持续时间、收缩压变异系数(SBPCV)、舒张变异系数(DBPCV)、脉压变异系数(PPCV)等均明显升高,差异有统计学意义(P<0.05)。多元Logistic回归分析显示:术中出血量、手术持续时间、SBPCV和PPCV是高血压合并下肢创伤性骨折患者术后DVT的独立危险因素(P<0.05);Pearson相关分析显示,术中出血量、手术持续时间、SBPCV和PPCV与高血压合并下肢创伤性骨折患者术后DVT均呈正相关(P<0.05)。结论高血压合并下肢创伤性骨折患者术后DVT与SBPCV和PPCV等IBPV指标密切相关。因此,临床需密切监测高血压合并下肢创伤性骨折患者的IBPV,以期通过降低IBPV预防术后DVT。

Objective To explore the correlation between postoperative deep vein thrombosis(DVT)and intraoperative blood pressure variability(IBPV)in patients with hypertension complicated with lower extremity traumatic fractures.Methods A retrospective study was performed on 196 patients with hypertension complicated with lower extremity traumatic fractures treated by surgery in the department of Orthopedics of our hospital from January 2019 to December 2021.According to the occurrence of postoperative deep vein thrombosis,they were divided into the DVT group(n=49)and the non-DVT group(n=147).The clinical data of the two groups were compared to analyze the correlation between postoperative DVT and IBPV.Results Compared with the group without DVT,age,BMI,proportion of general anesthesia,intraoperative blood loss,duration of surgery,SBPCV,DBPCV and PPCV were significantly increased in DVT group,with statistical significance(P<0.05).Multivariate Logistic regression analysis showed that intraoperative blood loss,operative duration,SBPCV and PPCV were independent risk factors for postoperative DVT in hypertension patients with lower extremity traumatic fracture(P<0.05).Pearson correlation analysis showed that postoperative DVT was positively correlated with intraoperative blood loss,operative duration,SBPCV and PPCV(all P<0.05).Conclusion Postoperative DVT is closely related to SBPCV,PPCV and other IBPV indexes in hypertensive patients with lower extremity traumatic fracture.Therefore,it is necessary to closely monitor the IBPV of patients with hypertension complicated with lower extremity traumatic fracture,so as to achieve the clinical purpose of reducing postoperative DVT by reducing IBPV.