急性重症胰腺炎患者下肢深静脉血栓形成的危险因素分析

Analysis of risk factors for lower extremity deep venous thrombosis in patients with acute severe pancreatitis

目的探讨急性重症胰腺炎患者住院期间发生下肢深静脉血栓的危险因素。方法收集2019年9月至2022年8月于新疆医科大学第一附属医院住院治疗的96例急性重症胰腺炎患者的临床资料,根据住院期间是否发生下肢深静脉血栓分为血栓组(n=13)和对照组(n=83)。比较两组患者住院期间的治疗情况。分析急性重症胰腺炎患者住院期间下肢深静脉血栓形成的危险因素。结果住院期间,两组患者液体治疗情况、镇痛情况、手术情况及抗生素使用情况比较,差异均无统计学意义(P﹥0.05)。单因素分析结果显示,血栓组患者的年龄大于对照组患者,入院时的C反应蛋白水平、D-二聚体水平均高于对照组患者,差异均有统计学意义(P﹤0.05)。多因素分析结果显示,年龄≥65岁、C反应蛋白水平﹥5 mg/L及D-二聚体水平﹥0.5 mg/L均是急性重症胰腺炎患者住院期间发生下肢深静脉血栓的独立危险因素(P﹤0.05)。结论年龄≥65岁、C反应蛋白水平﹥5 mg/L及D-二聚体水平﹥0.5 mg/L会增加急性重症胰腺炎患者住院期间发生下肢深静脉血栓的风险。

Objective To analyze the risk factors of lower extremity deep venous thrombosis in patients with acute severe pancreatitis during hospitalization.Method The clinical data of 96 patients with acute severe pancreatitis who were hospitalized in the First Affiliated Hospital of Xinjiang Medical University from September 2019 to August 2022 were collected,they were divided into the thrombosis group(n=13)and the control group(n=83)according to whether lower extremity deep venous thrombosis occurred during hospitalization.The treatment of the two groups of patients during hospitalization was compared.The risk factors of lower extremity deep venous thrombosis in patients with acute severe pancreatitis during hospitalization were also analyzed.Result During hospitalization,there were no statistically significant differences in fluid therapy,analgesia,surgery,and antibiotic use between the two groups(P>0.05).The results of the univariate analysis showed that patients in the thrombosis group were older than those in the control group,their C-reactive protein level and D-dimer level at admission were higher than those in the control group,and the differences were statistically significant(P<0.05).Multivariate analysis showed that age≥65 years,C-reactive protein level>5 mg/L and D-dimer level>0.5 mg/L were independent risk factors for lower extremity deep venous thrombosis during hospitalization in patients with severe acute pancreatitis(P<0.05).Conclusion Age≥65 years,C-reactive protein level>5 mg/L and D-dimer level>0.5 mg/L could increase the risk of lower extremity deep venous thrombosis during hospitalization in patients with severe acute pancreatitis.