肾移植患者术后下肢深静脉血栓发生的影响因素与预防

Factors Influencing the Development and Prevention of Postoperative Lower Extremity Deep Vein Thrombosis in Re⁃nal Transplant Patients

目的:探讨肾移植术后下肢深静脉血栓(LEDVT)形成的相关影响因素,总结预防措施。方法:回顾性分析2016年1月—2022年1月郑州市第七人民医院收治的685例肾移植手术患者的临床资料,术后均随访至2023年2月。按照随访期间有无LEDVT形成分为观察组(LEDVT)和对照组(无LEDVT)。比较两组患者一般资料,采用多因素logistic回归分析法分析影响肾移植患者术后LEDVT形成的重要因素。结果:随访期间,33例(4.82%)患者出现LEDVT,纳入观察组;652例(95.18%)患者均未出现LEDVT,纳入对照组。两组患者不同年龄、合并糖尿病、术后首次活动时间及术后红细胞增多症占比比较,差异有统计学意义(χ^(2)=4.574、11.502、3.921、4.033,P<0.05);多因素logistic回归分析显示,年龄、合并糖尿病、术后首次活动时间及术后红细胞增多症是肾移植术后LEDVT形成的影响因素(OR=1.323、2.413、1.856、1.754,P<0.05)。结论:肾移植患者术后LEDVT形成影响因素较多,包括年龄、合并糖尿病、术后首次活动时间及术后红细胞增多症,需根据这些影响因素加强早期预防干预。

Objective:To investigate the influencing factors related to the formation of lower extremity deep vein thrombosis(LEDVT)after renal transplantation and to summarize the preventive measures.Methods:The clinical data of 685 renal transplan⁃tation patients admitted to the hospital from January 2016 to January 2022 were retrospectively analyzed,and all were followed up until February 2023 after surgery.Patients were divided into observation group(LEDVT)and control group(no LEDVT)according to the presence or absence of LEDVT formation during the follow-up period.The general data of the patients in the two groups were compared,and the significant factors influencing the formation of postoperative LEDVT in renal transplant patients were ana⁃lyzed using multifactorial logistic regression analysis.Results:During the follow-up period,33 patients(4.82%)developed LEDVT and were included in the observation group,while 652 patients(95.18%)all did not develop LEDVT and were included in the con⁃trol group.There was statistically significant difference between the observation group and the control group patients by age,com⁃bined diabetes,time to first postoperative activity and percentage of postoperative erythrocytosis(χ^(2)=4.574,11.502,3.921,4.033,P<0.05).Multifactorial logistic regression analysis showed that age,combined diabetes,time to first postoperative activity and post⁃operative erythrocytosis were factors influencing the formation of LEDVT after renal transplantation(OR=1.323,2.413,1.856,1.754,P<0.05).Conclusion:There are many factors affecting the formation of postoperative LEDVT in renal transplant patients,including age,combined diabetes mellitus,time to first postoperative activity and postoperative erythrocytosis,and early preventive interventions need to be enhanced based on these influencing factors.