下肢深静脉血栓非手术疗法治疗后复发的影响因素

目的探讨非手术疗法治疗下肢深静脉血栓复发的影响因素,以提出改善预后的干预措施。方法采用病例对照研究的方法,将2004年2月至2008年4月行血管外科非手术治疗的下肢深静脉血栓患者167例按出院后18个月内是否复发分为复发与未复发两组,在收集病历资料和进行电话随访的基础上,通过单因素分析和非条件Logistic逐步回归分析复发的影响因素。结果非条件Logistic逐步回归分析表明,高龄、有骨科疾病及手术史、妊娠、不穿弹力袜或不使用绷带、未按时口服抗凝药物是非手术疗法治疗下肢深静脉血栓复发的危险因素,OR值分别为3.616、1.560、9.296、1.973、7.959。结论作为预防下肢深静脉血栓复发的保护因素,应嘱患者按时口服抗凝药物、下床时穿弹力袜或使用绷带;而对于高龄、有骨科疾病及手术史、妊娠者更要加强护理干预,积极预防下肢深静脉血栓形成的复发。

Influencing Factors of Recurrence of Deep Venous Thrombosis in Lower Extremities after Non-surgical Therapy

Objective To explore the influencing factors of recurrence of deep venous thrombosis in lower extremities following non-surgical treatment so as to propose the intervention strategies for improving the prognosis.Methods Using case-control method,167 patients with non-surgical treatment for deep venous thrombosis in lower extremity from February 2004 through April 2008 in the department of vascular surgery were divided into two groups according to whether there was a recurrence after discharge from hospital within one year and a half.Then single factor analysis and unconditional Logistic regression analysis were conducted based on the collection of medical records and telephone follow-ups.Results Non-conditional Logistic regression analysis showed that age,a bone disease and surgery,pregnancy,avoidance of wearing elastic stockings or bandages,irregular use of oral anticoagulant drugs were the risk factors of recurrent of deep venous thrombosis,whose OR values were 3.616,1.560,9.296,1.973,7.959 respectively.Conclusion As the protective factors of prevention of recurrence of deep venous thrombosis,patients should be suggested to take oral anticoagulant drugs on time,get out of bed wearing elastic stockings or bandages.while for elderly patients,patients with a bone disease and surgery and pregnant women,nursing intervention should be strengthened actively to prevent recurrence of deep vein thrombosis in low extremeties.