髋部骨折病人术前下肢深静脉血栓形成危险因素的Meta分析

[目的]通过Meta分析明确髋部骨折病人术前下肢深静脉血栓形成的危险因素,为有效预防下肢深静脉血栓提供科学依据。[方法]系统检索PubMed、EMbase、EBSCO、Cochrane Library、Web of science、中国知网(CNKI)、万方数据库(Wanfang)、中国生物医学文献数据库(CBM)、维普中文生物医学期刊数据库(VIP)关于髋部骨折病人术前下肢深静脉血栓形成危险因素的研究,检索时间限定建库至2019年4月,语种为中英文。由2名研究者按照纳入和排除标准筛选文献并提取资料,采用Newcastle-Ottawa Scale质量评价标准评价文献质量,RevMan5.3软件进行Meta分析,提取影响髋部骨折病人术前深静脉血栓形成的危险因素。[结果]共纳入15篇文献,累积病例9 778例,其中发生深静脉血栓的病人983例(10.05%)。Meta分析结果显示合并OR值:既往缺血性脑血管病、骨折前长期卧床、静脉血栓栓塞史、性别、合并其他系统疾病、高脂血症、体质指数(BMI)、骨折至入院时间≥24 h、合并其他创伤、合并高凝状态、D-二聚体、年龄≥45岁、股骨粗隆骨折、骨折至手术时间是髋部骨折病人术前深静脉血栓形成的危险因素,差异有统计学意义(P<0.05)。[结论]临床医护人员应针对主要危险因素,加强围术期管理,以预防髋部骨折病人术前深静脉血栓的发生。

Risk factors of preoperative deep venous thrombosis on lower limbs in patients with hip fracture:a meta-analysis

Objective:To clarify the risk factors of preoperative deep venous thrombosis of the lower extremity in patients with hip fractures through meta-analysis,and provide a scientific basis for effective prevention.Methods:Studies of the risk factors of preoperative deep venous thrombosis of the lower extremity in patients with hip fractures were retrieved from PubMed,EMbase,EBSCO,Cochrane Library,Web of Science,China Knowledge Network(CNKI),Wanfang database,Chinese biomedical literature database(CBM),and Weipu Chinese biomedical journal database(VIP)from the establishment of databases to April 2019 in Chinese and English.Two researchers screened the literature and extracted the data according to the inclusion and exclusion criteria.The Newcastle-Ottawa Scale quality evaluation criteria were used to evaluate the quality of the literature.RevMan5.3 software was used for meta-analysis to extract the risk factors that affect the preoperative deep vein thrombosis in the hip fracture patients.Results:A total of 15 articles were included,with a total of 9778 cases,involving 983 patients(10.05%)with deep vein thrombosis.Meta-analysis results showed that the combined OR value:previous ischemic cerebrovascular disease,long-term bed rest before fracture,and history of venous thromboembolism,gender,combined with other system diseases,hyperlipidemia,body mass index(BMI),time from fracture to admission≥24 h,combined with other trauma,combined hypercoagulable state,D-dimer,age≥45 years,femoral trochanter fracture,and the time from fracture to the operation were the risk factors for preoperative deep vein thrombosis in hip fracture patients,the difference was statistically significant(P<0.05).Conclusions:Clinical medical staff should strengthen the perioperative management according to the main risk factors to prevent the occurrence of preoperative deep vein thrombosis in patients with hip fracture.