老年股骨颈骨折患者围术期DVT发生现状及影响因素、应对策略分析

Analysis of the current status,influencing factors,and coping strategies of perioperative DVT in elderly patients with femoral neck fractures

目的探讨老年股骨颈骨折患者围术期下肢深静脉血栓(DVT)发生情况,分析影响因素、应对策略。方法回顾性分析2020年12月-2023年10月南昌大学第二附属医院收治的126例老年股骨颈骨折患者的临床资料,均行手术治疗,统计围术期DVT发生例数,分为DVT组和非DVT组,并收集患者性别、年龄、吸烟史、体重指数(BMI)、损伤类型、受伤至手术时间、手术方式、手术时间等一般资料,使用单因素、多因素分析影响老年股骨颈骨折患者下肢DVT的相关因素。结果126例老年股骨颈骨折患者中,21例围术期发生DVT(DVT组,16.67%),105例未发生DVT(非DVT组,83.33%);单因素分析显示,两组性别、BMI、合并高血脂症、手术方式比较,差异无统计学意义(P>0.05);两组年龄、吸烟史、损伤类型、受伤至手术时间、手术时间比较,差异有统计学意义(P<0.05);Logistic回归分析显示:年龄≥80岁、有吸烟史、高能量损伤、受伤至手术时间>3d、手术时间>2h均是老年股骨颈骨折患者围术期DVT发生的高危因素(P<0.05)。结论老年股骨颈骨折患者围术期存在一定DVT发生风险,与年龄、吸烟史、损伤类型、受伤至手术时间、手术时间均相关,临床需加以重视,据此采取有效应对策略。

Objective To explore the incidence of lower limb deep vein thrombosis(DVT)in elderly patients with femoral neck fractures during the perioperative period,analyze the influencing factors and coping strategies.Method A retrospective analysis was conducted on the clinical data of 126 elderly patients with femoral neck fractures admitted to our hospital from December 2020 to October 2023,all of whom underwent surgical treatment.The number of perioperative DVT cases was counted and divided into DVT group and non DVT group.General data such as patient gender,age,smoking history,body mass index(BMI),injury type,time from injury to surgery,surgical method,and surgical time were collected.Single factor and multi factor analyses were used to analyze the relevant factors affecting lower limb DVT in elderly patients with femoral neck fractures.Results Among 126 elderly patients with femoral neck fractures,21 cases experienced DVT during the perioperative period(DVT group,16.67%),and 105 cases did not experience DVT(non DVT group,83.33%);univariate analysis showed that there was no statistically significant difference between the two groups in terms of gender,BMI,concurrent hyperlipidemia,and surgical methods(P>0.05);there was a statistically significant difference(P<0.05)in age,smoking history,injury type,time from injury to surgery,and surgery time between the two groups;Logistic regression analysis showed that age≥80 years old,smoking history,high-energy injury,injury to surgery time>3 days,and surgery time>2 hours were all high-risk factors for perioperative DVT in elderly patients with femoral neck fractures(P<0.05).Conclusion There is a certain risk of DVT occurrence in elderly patients with femoral neck fractures during the perioperative period,which is related to age,smoking history,injury type,injury to surgery time,and surgery time.Clinical attention should be paid to this and effective coping strategies should be adopted accordingly.