老年重症脑卒中患者住院期间发生下肢深静脉血栓的危险因素

Risk factors for lower extremity deep vein thrombosis in elderly patients with severe stroke during hospitalization

目的 探讨老年重症脑卒中患者住院期间发生下肢深静脉血栓(DVT)的危险因素。方法 收集2021年9月至2022年6月首都医科大学附属北京天坛医院收治的100例老年重症脑卒中患者的临床资料,根据住院期间是否发生下肢DVT将患者分为DVT组(n=37)和对照组(n=63)。比较两组患者的临床特征、脑卒中病情及住院期间主要治疗情况,分析老年重症脑卒中患者住院期间发生下肢DVT的危险因素。结果 DVT组患者的年龄、合并骨性关节炎的比例均高于对照组患者,体重指数(BMI)低于对照组患者,差异均有统计学意义(P﹤0.05)。DVT组患者住院期间使用呼吸机的比例高于对照组患者,差异有统计学意义(P﹤0.05)。多因素分析结果显示,高龄、合并骨性关节炎、住院期间使用呼吸机及BMI﹤22 kg/m2均是老年重症脑卒中患者住院期间发生下肢DVT的独立危险因素(P﹤0.05)。结论 老年重症脑卒中患者住院期间发生下肢DVT与年龄、是否合并骨性关节炎、住院期间使用呼吸机情况及BMI密切相关,应充分评估患者的这些指标,并强化针对性干预措施。

Objective To investigate the risk factors for lower extremity deep vein thrombosis(DVT)in elderly patients with severe stroke during hospitalization.Method The clinical data of 100 elderly patients with severe stroke admitted to Beijing Tiantan Hospital,Capital Medical University from September 2021 to June 2022 were collected.Patients were divided into DVT group(n=37)and control group(n=63)according to whether lower extremity DVT occurred during hospitalization.The clinical features,stroke conditions,and main treatments during hospitalization were compared between the two groups.The risk factors for lower extremity DVT in elderly patients with severe stroke during hospitalization were analyzed.Result The age and proportion of patients with osteoarthritis in the DVT group were higher than those of the patients in the control group,and their body mass index(BMI)was lower than that of the patients in the control group,and the differences were statistically significant(P<0.05).The proportion of patients using ventilators in the DVT group during hospitalization was higher than that of patients in the control group,and the difference was statistically significant(P<0.05).Multivariate analysis results showed that advanced age,combined with osteoarthritis,use of ventilators during hospitalization,and 2 BMI<22 kg/m were all independent risk factors for lower extremity DVT in elderly patients with severe stroke during hospitalization(P<0.05).Conclusion The occurrence of lower extremity DVT in elderly patients with severe stroke during hospitalization is closely related to age,combined with osteoarthritis,the use of ventilators during hospitalization,and BMI.Patients should be fully evaluated for these indicators and targeted interventions should be strengthened.