下肢静脉曲张患者术后预后不良的危险因素

Risk factors for poor postoperative prognosis in patients with lower extremity varicose veins

目的 探讨下肢静脉曲张患者术后预后不良的危险因素。方法 收集2020年8月至2022年1月合肥市滨湖医院收治的150例下肢静脉曲张患者的临床资料,根据术后预后情况将患者分为预后不良组(n=55)和预后良好组(n=95)。采用多因素Logistic回归模型分析下肢静脉曲张患者术后预后不良的危险因素,采用受试者工作特征(ROC)曲线分析各危险因素对下肢静脉曲张患者术后预后不良的预测价值。结果 单因素分析结果显示,预后不良组患者的年龄明显大于预后良好组患者,体重指数(BMI)、糖尿病比例、D-二聚体(D-D)水平均明显高于预后良好组患者,手术时间、病程均明显长于预后良好组患者,差异均有统计学意义(P﹤0.01)。多因素分析结果显示,年龄、BMI、手术时间、糖尿病、病程、D-D水平均为下肢静脉曲张患者术后预后不良的独立危险因素(P﹤0.05)。ROC曲线分析结果显示,年龄、BMI、手术时间、病程、D-D的曲线下面积(AUC)分别为0.704、0.660、0.902、0.735、0.769,最佳截断值分别为55岁、25.17 kg/m^(2)、62 min、5年、0.04μg/ml。结论 年龄、BMI、手术时间、糖尿病、病程、D-D水平均为下肢静脉曲张患者术后预后不良的危险因素,临床中应注意对这些高危患者给予针对性监测和预防。

Objective To analyze the risk factors for poor postoperative prognosis in patients with lower extremity varicose veins.Method Clinical data of 150 patients with lower extremity varicose veins who were treated in the Hefei Binhu Hospital from August 2020 to January 2022 were collected and all patients were divided into the poor prognosis group(n=55)and the good prognosis group(n=95)according to the postoperative prognosis.The risk factors for poor postoperative prognosis in patients with lower extremity varicose veins were analyzed by multivariate Logistic regression model,and predictive value of each risk factor postoperative poor prognosis was analyzed by receiver operating characteristic(ROC)curve.Result The univariate analysis showed that the age of patients in the poor prognosis group was significantly older than that in the good prognosis group,the body mass index(BMI),the proportion of diabetes,and the level of D-dimer(D-D)were significantly higher than those in the good prognosis group,and the duration of surgery and disease duration were significantly longer than those in the good prognosis group,and the differences were statistically significant(P<0.01);the multivariate analysis showed that age,BMI,duration of surgery,diabetes,disease duration and D-D level were independent risk factors for postoperative poor prognosis in patients with lower extremity varicose veins(P<0.05);the results of ROC curve showed that the AUC for age,BMI,duration of surgery,disease duration,and D-D were 0.704,0.660,0.902,0.735,0.769,and the best cut-off values were 55 years,25.17 kg/m^(2),62 min,5 years,and 0.04μg/ml,respectively.Conclusion Age,BMI,duration of surgery,diabetes,disease duration,and D-D level are all risk factors for poor postoperative prognosis in patients with lower extremity varicose veins,and targeted monitoring and prevention should be given in clinical practice.