骨科创伤患者术前发生静脉血栓栓塞的危险因素分析

Analysis of risk factors for preoperative venous thromboembolism in orthopedic trauma patients

目的 探讨骨科创伤患者术前发生静脉血栓栓塞(VTE)的危险因素。方法 收集2020年1月至2022年12月于首都医科大学附属北京友谊医院住院接受手术治疗的86例骨科创伤患者的临床资料,根据手术之前是否发生VTE将患者分为VTE组和对照组,每组43例。比较两组患者的临床特征,采用多因素Logistic回归模型分析骨科创伤患者术前发生VTE的危险因素。结果 VTE组患者的年龄、D-二聚体水平、下肢创伤的比例、大腿周径差均高于对照组患者,差异均有统计学意义(P<0.05)。两组患者的性别、吸烟情况、饮酒情况、高血压情况、糖尿病情况、体重指数、收缩压、白细胞计数、血红蛋白水平、血小板计数、血糖水平、总胆固醇水平、甘油三酯水平、谷丙转氨酶水平、肌酐水平、国际标准化比值、小腿周径差以及感染、休克、开放性创伤的比例比较,差异均无统计学意义(P>0.05)。多因素分析结果显示,老年(年龄≥65岁)、D-二聚体水平升高(>500μg/L)、大腿周径差>2 cm及下肢创伤均是骨科创伤患者术前发生VTE的独立危险因素(P<0.05)。结论 年龄、D-二聚体水平、大腿周径差及创伤部位均与骨科创伤患者术前发生VTE密切相关。

Objective To analyze the risk factors for preoperative venous thromboembolism(VTE)in orthopedic trauma patients.Method The clinical data of 86 patients who were hospitalized and underwent surgical treatment in the Beijing Friendship Hospital,Capital Medical University from January 2020 to December 2022 were collected.According to whether VTE had occurred before the surgery,the patients were divided into the VTE group and the control group,with 43 cases patients in each group.The Clinical characteristics between the two groups of patients were compared,and further use multivariate Logistic regression model to analyze the risk factors related to preoperative VTE in orthopedic trauma patients.Result The age,D-dimer level,ratio of lower extremity trauma and thigh circumference difference in VTE group were higher than those in the control group,all the differences above were statistically significant(P<0.05).There was no significant difference between the two groups in terms of gender,smoking,drinking,hypertension,diabetes,body mass index,systolic pressure,white blood cell count,hemoglobin level,platelet count, blood glucose level, total cholesterol level, triglyceride level, alanine aminotransferase level, creatinine level, international standardized ratio, infection ratio, shock ratio and open trauma ratio, and leg circumference difference (P>0.05) .Multivariate analysis showed that elderly (≥65 years old), elevated D-dimer level (>500 μg/L), thigh circumference difference>2 cm, and lower extremity trauma were risk factors for preoperative VTE in orthopedic trauma patients. Conclusion Age, D-dimer, thigh circumference difference and trauma site are closely related to preoperative VTE in orthopedic trauma patients.