下肢软组织创伤并发深静脉血栓易患风险因素分析

Risk Factors of Deep Vein Thrombosis after Soft Tissue Trauma of Lower Extremities

目的回顾性分析下肢软组织创伤患者并发深静脉血栓(DVT)的易患风险因素,为防治DVT提供参考。方法收集2020年1月至2021年12月间单中心收治的下肢软组织创伤患者的一般临床资料、创伤情况、实验室检查资料、影像学检查资料、临床管理情况、并发症等因素进行统计分析,分析下肢软组织创伤并发DVT的易患风险因素。结果363例下肢软组织创伤患者中DVT发生率为8.8%,DVT累及髂静脉1例,股静脉1例,腘静脉3例,胫后静脉3例,腓静脉3例,肌间静脉31例。DVT组和非DVT组患者在年龄、性别、吸烟、饮酒、心脏病、创伤类型、创伤严重程度、血红蛋白、纤维蛋白降解产物(FDP)、D-二聚体、入院等待时间、未预防性抗凝、创伤后局部感染、软组织缺损方面差异有统计学意义(P<0.05)。经多因素logistics回归分析后显示年龄、吸烟、创伤后局部感染、入院等待时间、未预防性抗凝、创伤严重程度、D-二聚体升高(>0.5μg/mL)是下肢软组织创伤后并发DVT的独立危险因素(P<0.05)。结论下肢软组织创伤并发DVT主要累及下肢肌间静脉,年龄、吸烟史、创伤后局部感染、入院等待时间、未预防性抗凝、创伤严重程度、D-二聚体升高(>0.5μg/mL)与DVT的发生密切相关。

Objective To retrospectively analyze the risk factors of deep vein thrombosis(DVT)in patients with soft tissue trauma of the lower extremities,and to provide reference for the prevention and treatment of DVT.Methods The general clinical data,trauma status,laboratory tests data,imaging data,clinical management information,complications,and other factors of patients with lower limb soft tissue trauma admitted to a single center from January 2020 to December 2021 were collected and statistically analyzed.The risk factors of lower limb soft tissue trauma complicated with DVT were analyzed.Results The incidence of deep vein thrombosis(DVT)in 363 patients with lower limb soft tissue trauma was 8.8%.DVT involved the iliac vein in 1 case,the femoral vein in 1 case,the popliteal vein in 3 cases,the posterior tibial vein in 3 cases,the peroneal vein in 3 cases,and the muscular veins in 31 cases.There were significant differences between the DVT group and the non-DVT group in terms of age,gender,smoking,alcohol consumption,heart disease,type and severity of trauma,hemoglobin,fibrin degradation products(FDP),D-dimer,waiting time for admission,lack of prophylactic anticoagulation,post-traumatic local infection,and soft tissue defects(P<0.05).Multivariate logistic regression analysis showed that age,smoking,post-traumatic local infection,waiting time for admission,lack of prophylactic anticoagu-lation,severity of trauma,and elevated D-dimer(>0.5µg/mL)were independent risk factors for DVT after lower limb soft tissue trauma(P<0.05).Conclusion DVT following soft tissue trauma of the lower limb mainly involves the intermuscular veins.Age,smoking history,local infection after trauma,waiting time for admission,unprotected anticoagulation,severity of trauma,and elevated D-dimer(>0.5µg/mL)is closely related to the occurrence of DVT.