[股骨颈骨折老年患者围手术期下肢深静脉血栓形成的风险因素]。

Q3 Medicine
Yonggang Wang, Kai Fu, Wei Zheng, Qianying Cai, Shengbao Chen, Changqing Zhang, Xianyou Zheng
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引用次数: 0

摘要

目的研究老年股骨颈骨折患者围手术期下肢深静脉血栓(DVT)的发生率及其风险因素:回顾性分析 2012 年 8 月至 2020 年 11 月期间收治的 4 109 例符合入选标准的老年股骨颈骨折患者的临床资料。其中,男性 1 137 例,女性 2 972 例;年龄在 65 岁至 101 岁之间,平均年龄为 77.0 岁。从骨折到入院的时间从 1 到 360 小时不等,平均为 35.2 小时。半髋关节置换术有1 858例,全髋关节置换术有1 617例,内固定手术有634例。术前年龄调整后的Charlson合并症指数(aCCI)为4(3,5)。围手术期发生深静脉血栓的病例有 857 例(20.9%)。对有和无围手术期深静脉血栓患者的年龄、性别、体重指数、骨折侧、骨折至入院时间、手术类型、麻醉类型、输血、入院后血压和术前 aCCI 进行单变量分析,并采用逻辑回归分析筛选老年股骨颈骨折患者围手术期深静脉血栓的风险因素:单变量分析显示,两组患者在年龄、性别、骨折至入院时间、手术类型、术前 aCCI(P75 岁、女性患者、骨折至入院时间>24 小时、术前 aCCI>5)等方面存在显著差异,均为股骨颈骨折围手术期深静脉血栓形成的危险因素:老年股骨颈骨折患者围术期深静脉血栓的发生率较高。高龄、女性、骨折时间较长、合并症较多的患者需要特别注意围手术期深静脉血栓的预防,以减少股骨颈骨折期间深静脉血栓的发生。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Risk factors of perioperative deep venous thrombosis of lower extremities in elderly patients with femoral neck fracture].

Objective: To investigate the incidence of perioperative deep venous thrombosis (DVT) of lower extremities and its risk factors in elderly patients with femoral neck fracture.

Methods: The clinical data of 4 109 elderly patients with femoral neck fracture admitted between August 2012 and November 2020 and met the selection criteria were retrospectively analyzed. Among them, there were 1 137 males and 2 972 females; their ages ranged from 65 to 101 years, with an average of 77.0 years. The time from fracture to admission ranged from 1 to 360 hours, with an average of 35.2 hours. There were 1 858 cases of hemiarthroplasty, 1 617 cases of total hip arthroplasty, and 634 cases of internal fixation surgery. The preoperative age-adjusted Charlson comorbidity index (aCCI) was 4 (3, 5). Perioperative DVT occurred in 857 cases (20.9%). Univariate analysis was performed on age, gender, body mass index, fracture side, time from fracture to admission, operation type, anesthesia type, blood transfusion, blood pressure after admission, and preoperative aCCI in patients with and without perioperative DVT, and logistic regression analysis was used to screen the risk factors of perioperative DVT in elderly patients with femoral neck fracture.

Results: Univariate analysis showed that there were significant differences in age, gender, time from fracture to admission, operation type, and preoperative aCCI between the two groups ( P<0.05). Further logistic regression analysis showed that age>75 years, female patients, time from fracture to admission>24 hours, and preoperative aCCI>5 were risk factors for perioperative DVT ( P<0.05).

Conclusion: Elderly patients with femoral neck fracture have a higher incidence of perioperative DVT. The advanced aged and female patients, patients with longer fracture time and more comorbidities need to pay special attention to the prevention of perioperative DVT to minimize the occurrence of DVT during femoral neck fractures.

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来源期刊
中国修复重建外科杂志
中国修复重建外科杂志 Medicine-Medicine (all)
CiteScore
0.80
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0.00%
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11334
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