中老年脑出血后深静脉血栓形成现状及影响因素

目的：调查中老年患者脑出血后急性期深静脉血栓形成（DVT）的发病率，并探讨DVT的影响因素。方法：选择2019年9月至2021年5月在温州医科大学附属第一医院就诊且发病24 h内住院的脑出血患者245例，在患者脑出血后10～14 d内进行双下肢静脉超声检查，得出脑出血后急性期DVT发病率。通过单因素分析和二元Logistic回归分析中老年患者脑出血后并发DVT的影响因素。结果：245例中老年脑出血患者中79例患者发生DVT，发病率为32.24%，其中39例（49.37%）无DVT的临床症状。二元Logistic回归分析显示，年龄≥70岁（OR=1.73,95%CI=1.12～2.98）、下肢美国国立卫生研究院卒中量表评分≥3分（OR=4.13,95%CI=2.15～8.97）、连续卧床时间≥3 d(OR=4.73,95%CI=2.25～9.78)、Wells评分≥2分（OR=3.54,95%CI=1.62～6.67）、入院时D-二聚体高（OR=3.06,95%CI=1.01～3.49）是脑出血后急性期DVT发生的独立危险因素，早期康复治疗是DVT发生的保护因素（OR=0.55,95%C...

Incidence of deep venous thrombosis after intracerebral hemorrhage in the middle-aged and elderly and its influencing factors

Objective: To investigate the incidence of acute deep vein thrombosis (DVT) after intracerebral hemorrhage in the middle-aged and elderly and explore its influencing factors, so as to provide reference for the prevention and nursing care. Methods: A total of 245 patients with cerebral hemorrhage hospitalized within 24 hours of onset in the First Affiliated Hospital of Wenzhou Medical University from September 2019 to May 2021 were selected. All patients underwent venous ultrasound examination of lower extremities 10-14 days after onset.The prevalence of DVT in the acute stage after cerebral hemorrhage was calculated. The influencing factors of DVT after intracerebral hemorrhage in middle-aged and elderly patients were analyzed by univariate analysis and binary logistic regression analysis. Results: Of 245 middle-aged and elder patients with intracerebral hemorrhage investigated, 79 cases had DVT, with the incidence rate of 32.24%, of which 39 cases (49.37%) had no clinical symptoms of DVT. Binary logistic analysis showed that age ≥70 years old (OR=1.73, 95%CI=1.12-2.98),NIHSS score of lower limbs score ≥3 points (OR=4.13, 95%CI=2.15-8.97), continuous bed time ≥3 days(OR=4.73, 95%CI=2.25-9.78), Wells ≥2 points (OR=3.54, 95%CI=1.62-6.67), and high D-dimer at admission (OR=3.06, 95%CI=1.01-3.49) were independent risk factors for DVT in the acute stage after cerebral hemorrhage.Early rehabilitation was a protective factor for DVT (OR=0.55, 95%CI=0.28-0.96). Conclusion: The incidence of DVT after intracerebral hemorrhage was high in the middle-aged and elderly, and nearly half of patients do not have clinical symptoms of DVT. Many independent risk factors are involved in DVT of the middle-aged and elderly patients with acute stroke. Timely monitor and intervention are suggested for patients with risk factors and early rehabilitation treatment of cerebral hemorrhage should be combined to reduce the occurrence of DVT.