髋臼及骨盆骨折患者术前深静脉血栓形成的影响因素

目的探讨影响髋臼及骨盆骨折患者术前深静脉血栓(DVT)形成的危险因素。方法回顾性分析287例髋臼及骨盆骨折患者临床资料及术前DVT检查结果,采用多因素非条件Logistic回归分析进行术前DVT危险因素分析。结果 287例手术患者术前37例检出DVT,发生率为12.89%。DVT组年龄40岁以上各组比例明显高于非血栓患者(P<0.05),术前卧床时间30d以上比例最高(P<0.05),合并高凝状态疾病组、合并其他创伤组、高能创伤组、吸烟组比例明显高于非血栓患者(P<0.05),D-D二聚体<500μg/L、术前抗凝预防措施组比例明显低于非血栓患者(P<0.05)。年龄、合并高凝状态、合并其他创伤、D-D二聚体水平是术前DVT形成的独立危险因素(P<0.05),术前抗凝预防措施是保护因素(P<0.05)。结论髋臼及骨盆骨折患者术前存在较高DVT形成风险,并与年龄增长、D-D二聚体水平升高、高凝状态及合并其他创伤密切相关,应加强重点人群的预防和筛查,术前低分子肝素抗凝预防治疗能有效降低DVT发生,但应结合出血风险,制定合理预防干预方法。

Clinical research on related factors of preoperative deep vein thrombosis of acetabular and pelvic fracture

Objective To analyze the effect of acetabular and pelvic fractures preoperative deep vein thrombosis risk factors. Methods Retrospective analyzed clinical data and DVT examination results of 287 cases with acetabular and pelvic fractures and preoperative, used non-conditional Logistic regression analysis of preoperative risk factors of DVT. Results A total of 287 cases of patients before surgery and 37 cases were found to DVT, the rate was 12.89%. DVT age group accounted for more than 40 in each group were significantly higher than non-thrombotic group （P 〈0.05）, preop- erative time in bed than more than 30d points were the highest （P 〈0.05）, hypercoagulable state disease group, com- bined with other trauma group, were significantly higher than the proportion of non-energy trauma thrombus group （P 〈 0.05） , DD dimer 〈500~g / L, preoperative anticoagulant prophylaxis measures group were significantly lower than the proportion thrombus group （P 〈0.05）. Age, hypercoagulable state, combined with other trauma, DD dimer formation were independent of preoperative risk factors for DVT（P 〈0.05）, preoperative anticoagulation precautions were protec- tive factors （P 〈0.05）. Conclusion Acetabular and pelvic fracture patients before, there are higher risk of DVT forma- tion, and with increasing age, DD dimer levels, hypercoagulable state and combined with other closely related trauma, focus groups should be strengthened prevention and screening, preoperative low molecular weight heparin prophylaxis can reduce the incidence of DVT, but the risk of bleeding should be combined with the development of rational preven- tive interventions.