脊髓损伤患者应用肢体血液循环泵致下肢深静脉血栓形成的相关因素分析

中国基层医药 Pub Date : 2020-04-01 DOI:10.3760/CMA.J.ISSN.1008-6706.2020.07.017

Yi-Hsun Yu, Li Xie

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引用次数: 0

摘要

目的探讨肢体血液循环泵治疗脊髓损伤（SCI）并发深静脉血栓形成（DVT）的独立危险因素。方法收集2016年1月至2018年12月绍兴市中心医院脊柱外科收治的胸腰段脊柱骨折合并SCI患者300例。患者术后接受血液循环泵预防DVT，48例DVT患者分为DVT组，其余252例患者分为非DVT组。收集基本信息（性别、年龄、身高、体重等）、体重指数（BMI）、慢性病状态（糖尿病、高血压、冠心病等）、吸烟史、合并下肢骨折、SCI分级、手术时间、术中失血量。分析DVT组与非DVT组上述指标的差异。将具有统计学差异的因素代入逻辑回归分析，以确定使用血液循环泵治疗的SCI患者DVT的独立危险因素。结果DVT组中老年患者（≥60岁）的比例高于非DVT组（79.17%vs.57.14%，χ2=8.196，P=0.004），DVT组肥胖患者（BMI≥25kg/m2）的比例大于非DVT（77.08%vs.56.35%，χ2=7.203，P=0.007），DVT组糖尿病患者比例高于非DVT组（68.75%vs.10.71%，χ2=84.877，P=0.000），DVT组吸烟者比例高于非DVDT组（81.25%vs.49.21%，χ2=16.685，P=0.0000），DVT组下肢骨折患者比例高于非DVT组（41.67%vs.7.14%，χ2=43.443，P=0.000），DVT组完全损伤患者比例高于无DVT组，吸烟史和下肢骨折是使用肢体血液循环泵的SCI患者发生DVT的独立危险因素（Or=1.138，1.356，1.548，P=0.003，0.007，0.014）。关键词：脊髓损伤；胸腰椎骨折；四肢血液循环泵；下肢深静脉血栓形成；糖尿病；吸烟史；下肢骨折；独立风险因素

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Analysis of related factors in deep venous thrombosis of lower extremity when using limb blood circulation pump in patients with spinal cord injury

Objective To investigate the independent risk factors of deep venous thrombosis (DVT) in patients with spinal cord injury (SCI) treated with limb blood circulation pump. Methods From January 2016 to December 2018, 300 patients of thoracolumbar spine fractures with SCI were collected in the department of spinal surgery of Shaoxing Central Hospital.The patients received blood circulation pump to prevent DVT after operation, 48 patients with DVT were classified as DVT group, and the remaining 252 patients were classified as non-DVT group.The basic information (sex, age, height, weight, etc.), body mass index (BMI), chronic disease status (diabetes, hypertension, coronary heart disease, etc.), smoking history, combined lower extremity fracture, SCI classification, operation time, intraoperative blood loss were collected.The differences of above indicators between the DVT group and the non-DVT group were analyzed.The factors with statistical differences were substituted into logistic regression analysis to identify independent risk factors for DVT in patients with SCI who were treated with blood circulation pump. Results The proportion of elderly patients (≥60 years old) in the DVT group was higher than that in the non-DVT group (79.17% vs.57.14%, χ2=8.196, P=0.004), and the proportion of obese patients (BMI≥25kg/m2) in the DVT group was higher than that in the non-DVT group(77.08% vs.56.35%, χ2=7.203, P=0.007), the proportion of patients with diabetes in the DVT group was higher than that in the non-DVT group (68.75% vs.10.71%, χ2=84.877, P=0.000), the proportion of smokers in the DVT group was higher than that in the non-DVT group(81.25% vs.49.21%, χ2=16.685, P=0.000), the proportion of patients with lower extremity fractures in the DVT group was higher than that in the non-DVT group (41.67% vs.7.14%, χ2=43.443, P=0.000), and the proportion of patients with complete injury in the DVT group was higher than that in the non-DVT group (45.83% vs.15.08%, χ2=23.834, P=0.000). Logistic regression analysis showed that diabetes, smoking history and lower extremity fractures were independent risk factors for DVT in SCI patients with limb blood circulation pump (Or=1.138, 1.356, 1.548, P=0.003, 0.007, 0.014). Conclusion The independent risk factors for DVT in SCI patients when using blood circulation pump may include diabetes, smoking history and lower extremity fractures. Key words: Spinal cord injury; Thoracolumbar spine fracture; Limb blood circulation pump; Lower extremity deep vein thrombosis; Diabetes mellitus; Smoking history; Lower limb fracture; Independent risk factor

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来源期刊

中国基层医药

CiteScore

0.10

自引率

0.00%

发文量

32251

期刊介绍： Since its inception, the journal "Chinese Primary Medicine" has adhered to the development strategy of "based in China, serving the grassroots, and facing the world" as its publishing concept, reporting a large amount of the latest medical information at home and abroad, prospering the academic field of primary medicine, and is praised by readers as a medical encyclopedia that updates knowledge. It is a core journal in China's medical and health field, and its influence index (CI) ranks Q2 in China's academic journals in 2022. It was included in the American Chemical Abstracts in 2008, the World Health Organization Western Pacific Regional Medical Index (WPRIM) in 2009, and the Japan Science and Technology Agency Database (JST) and Scopus Database in 2018, and was included in the Wanfang Data-China Digital Journal Group and the China Academic Journal Comprehensive Evaluation Database.