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腹部创伤患者发生深静脉血栓的影响因素
引用本文:张建涛,吴畏,钱惠岗,陈光安.腹部创伤患者发生深静脉血栓的影响因素[J].重庆医学,2016(19).
作者姓名:张建涛  吴畏  钱惠岗  陈光安
作者单位:青海省人民医院急诊外科,西宁,810007
基金项目:青海省科技厅资助项目(q632013Y0113)。
摘    要:目的:分析腹部创伤患者发生深静脉血栓的影响因素。方法选取2014年6月至2015年6月该院收治的腹部创伤患者200例,均经彩色多普勒超声检查是否发生深静脉血栓,回顾性分析患者的临床资料,对腹部创伤患者发生深静脉血栓的影响因素进行分析。结果200例患者中56例在腹部创伤后7 d内表现出肌肉压痛、胀痛、Homans征阳性、浅静脉曲张和肢体皮温降低等症状与体征,经彩色多普勒超声检查60例患者确诊发生深静脉血栓。多因素Logistic回归分析结果显示,高龄、高胆固醇水平、高D‐二聚体水平、高尿素氮水平、合并高血压、合并糖尿病、合并高脂血症、术前1个月有手术史、下腹部创伤、高创伤评分、卧床时间大于3 d及有感染为腹部创伤患者发生深静脉血栓的独立危险因素(P<0.05)。结论临床应对存在深静脉血栓危险因素的腹部创伤患者进行彩色多普勒超声筛查,有利于深静脉血栓的早发现、早治疗。

关 键 词:腹部创伤  深静脉血栓  危险因素

Influencing factors of deep venous thrombosis in patients with abdominal trauma
Zhang Jiantao,Wu Wei,Qian Huigang,Chen Guang′an.Influencing factors of deep venous thrombosis in patients with abdominal trauma[J].Chongqing Medical Journal,2016(19).
Authors:Zhang Jiantao  Wu Wei  Qian Huigang  Chen Guang′an
Abstract:Objective To analyze the influencing factors of deep vein thrombosis (DVT ) in the patients with abdominal trau‐ma .Methods A total of 200 cases of patients with abdominal trauma in our hospital from June 2014 to June 2015 were selected and performed the color Doppler ultrasonography for determining whether DVT occurring .The clinical data were retrospectively ana‐lyzed .The influencing factors of DVT occurrence in the patients with abdominal trauma were analyzed .Results Among 200 cases of abdominal trauma ,56 cases appeared the symptoms and signs of muscular pressing pain ,swelling pain ,positive Homans sign ,su‐perficial varicose and skin temperature decrease within 7 d after abdominal trauma ,60 cases were diagnosed as DVT by color Doppler ultrasonography .The multivariate Logistic regression analysis results showed that advanced age ,high cholesterol level ,high D‐dimer level ,high blood urea nitrogen level ,complicating hypertension ,complicating diabetes ,complicating hyperlipidemia ,surgical history at preoperative 1 month ,lower abdominal trauma ,high score of trauma ,bedridden time more than 3 d and infection were the independent risk factors of DVT occurrence in abdominal trauma patients (P<0 .05) .Conclusion Clinic should perform the color Doppler ultrasound screening in the abdominal trauma patients with risk factors of DVT ,which is conducive to early discovery and early treatment of DVT .
Keywords:abdominal trauma  deep vein thrombosis  risk factors
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