腹股沟疝患者术后下肢深静脉血栓的风险评估及对策

目的评估腹股沟疝患者术后形成深静脉血栓（deep vein thrombosis，DVT）的风险，针对不同风险级别给予相应对策。 方法回顾性分析2015年3月至2018年1月，中国医科大学附属盛京医院收治的腹股沟疝行手术治疗556例患者的相关临床资料，经Caprini血栓风险评估量表评估风险等级分为4个级别：低危、中危、高危、极高危，每一级别再根据术后是否进行抗凝治疗分为抗凝组和未抗凝组，统计患者术后形成DVT人数，应用χ²检验对相关结果进行统计学分析。 结果低、中危级别患者共72例，术后未见DVT形成。极高危级别患者369例，抗凝组术后DVT形成者有7例，未抗凝组DVT形成者为15例，差异有统计学意义（χ²=20.379，P<0.05）；高危级别患者113例，抗凝组术后形成DVT者3例，未抗凝组术后DVT形成者7例，差异有统计学意义（χ²=5.744，P<0.05）。中危级别2组比较，差异无统计学意义（P>0.05）。 结论腹股沟疝术后的根据风险分级合理预防治疗，可减少术后发生DVT风险。

Risk assessment and countermeasures of deep venous thrombosis of patients after inguinal hernia surgery

ObjectiveTo assess the risk of developing deep vein thrombosis (DVT) after inguinal hernia surgery, and to provide corresponding countermeasures for different risk levels. MethodsA retrospective analysis was conducted on patients undergoing surgery for inguinal hernia in Shengjing Hospital from March 2015 to January 2018. The risk scores were assessed by the Caprini Thrombosis Risk Assessment Scale into four groups: low-risk, intermediate-risk, high-risk, and extremely high-risk. Each group was divided into anticoagulation group and non-anticoagulant group according to whether anticoagulation treatment was performed after operation. The number of DVT patients after inguinal hernia was counted, and the results were statistically analyzed by chi-square test. ResultsA total of 72 patients with low-and intermediate-risk grades did not develop DVT after operation; 369 patients were in the extremely high-risk class, 7 patients developed DVT in the anticoagulation group, and 15 patients in the non-anticoagulation group, the difference was not statistically significant (χ²=20.379, P<0.05); 113 patients with high-risk grade, 3 patients with DVT in anticoagulation group, and 7 patients with DVT in non-anticoagulation group, The above differences were statistically significant (χ²=5.744, P<0.05). Patients with intermediate-risk level, the difference was not statistically significant(P>0.05). ConclusionReasonable prevention and treatment according to risk classification after inguinal hernia can reduce the risk of postoperative DVT.