骨科创伤患者术后下肢深静脉血栓的因素与临床治疗

目的 探讨骨科创伤患者术后形成下肢深静脉血栓（DTV）的影响因素及临床治疗.方法 选取云南省第二人民医院急创伤中心2010年3月～2013年3月收治的下肢骨折创伤患者50例,术后发生DTV者25例为DVT组;术后未发生DVT者25例为对照组.记录所有患者的自身病因及手术相关因素以比较这些因素对DVT形成的影响.比较DTV组采用机械辅助药物治疗与综合手术治疗的效果.结果 ①DTV组患者中有高血压、糖尿病、血栓史的比例明显高于对照组,差异有统计学意义（P＜0.05）;而两组吸烟酗酒的比例比较,差异无统计学意义（P＞0.05）.②DTV组患者手术时间（3.98 ±0.28） min]及制动时间（8.21±1.36）min]明显长于对照组（2.34±0.35）、（4.67±0.89）min],差异有统计学意义（P＜0.05）.③DTV组患者中机械配合药物的治疗综合效果为63.7％（7/11）,低于综合手术治疗的85.7％ （12/14）,差异有统计学意义（P＜0.05）.结论 骨科创伤患者术后形成下肢DVT的原因不仅与手术操作等外在因素有关,还跟自身带有的一些高血压、糖尿病等内在因素有关,因此需要综合治疗才能达到最佳效果.

Factors analysis and clinical treatment of the patients after surgery with deep venous thrombosis

Objective To evaluate factors and clinical treatment of the patients after surgery with deep venous thrombosis （DVT）.Methods 50 patients with lower limb fractures trauma after surgery in Trauma Care Center of the Second People＇s Hospital of Yunnan Province from March 2010 to March 2013 were selected.25 cases with DTV were distributed into DTV group,25 cases without DVT were chosen as control group.The past medical history and surgery related factors were recorded to analyze the factors of the patients after surgery with DVT.The clinical effects of machinery-drug treatment or comprehensive surgical treatment in DTV group were observed and compared.Results ①The ratio of high blood pressure,diabetes mellitus,thrombus history itself in DTV group were all higher than those in control group,the differences were statistically significant （P ＜ 0.05）; the difference of smoking combined with drinking between the two groups was not statistically significant （P ＞ 0.05）.②The operation time,braking time in DTV group （3.98±0.28）,（8.21±1.36） min] were all longer than those in control group （2.34±0.35）,（4.67±0.89） min],the differences were statistically significant （P ＜ 0.05）.③The comprehensive treatment effect with machinery and drugs in DTV group was 63.7％ （7/11）,the comprehensive treatment effect with machinery and drugs in control group was 85.7％ （12/14）,the difference was statistically significant （P ＜ 0.05）.Conclusion The factors of the patients after surgery with DVT are related with surgery-related factors and the past medical history,so it needs a comprehensive treatment to achieving the better results.