脊髓损伤患者并发下肢深静脉血栓危险因素的回顾性研究

Risk factors for deep vein thrombosis after a spinal cord injury:A retrospective study

目的探讨脊髓损伤患者并发下肢深静脉血栓(DVT)的危险因素。方法回顾性分析2018年1月至2022年9月于空军军医大学第一附属医院康复医学科住院的276例脊髓损伤患者的临床资料,按入院后是否合并下肢DVT,将其分为DVT组(63例)和非DVT组(213例)。比较两组患者的性别、年龄、血型、吸烟史、手术史、入院距离脊髓损伤的时间、脊髓损伤原因、骨折情况、脊髓损伤节段、美国脊髓损伤协会(AISA)分级、合并症等相关指标,采用二分类Logistics回归分析筛选脊髓损伤患者合并下肢DVT的危险因素。结果276例脊髓损伤患者中,有63例(22.83%)出现下肢DVT,其中84.13%为小腿肌间静脉血栓(CMVT)。二分类Logistic回归分析结果显示,脊髓损伤患者合并下肢DVT,与贫血[OR=2.753,95%CI(1.233,6.146),P=0.013]、低钠血症[OR=5.349,95%CI(1.970,14.525),P=0.001]、入院距离脊髓损伤的时间[74~195 d,OR=0.231,95%CI(0.084,0.636),P=0.005;≥195 d,OR=0.124,95%CI(0.034,0.451),P=0.002]有关。结论脊髓损伤患者发生下肢DVT的风险较高,贫血、低钠血症是其独立危险因素。

Objective To explore the risk factors for lower extremity deep vein thrombosis(DVT)in patients with a spinal cord injury(SCI).Methods The medical records of 276 hospitalized SCI patients were analyzed retrospectively.They were divided into a DVT group(n=63)and a no-DVT group(n=213).Gender,age,blood type,smoking history,surgical history,the time from SCI to admission,cause of SCI,fracture,SCI segments,American Spinal Cord Injury Association grade and complications were compared between the two groups.Binomial logistic regression was used to isolate the risk factors for lower extremity DVT among such patients.Results Among 84%of the 63 with a lower extremity DVT,it was a calf muscle venous thrombosis.Anemia,hyponatremia and time from SCI to admission(which ranged from 74 to 195 days)were the most serious DVT risk factors.Conclusions SCI patients are of high risk for DVT,with anemia and hyponatremia being independent risk factors.