天津医药

• 论著 •    

骨折术后深静脉栓塞的危险因素分析

杨兴光1,孙忠1,王学谦2,陆云2   

  1. 1. 天津医科大学公共卫生学院卫生统计学教研室
    2. 天津市天津医院
  • 收稿日期:2009-10-27 修回日期:2009-12-14 出版日期:2010-06-15 发布日期:2010-06-15
  • 通讯作者: 孙忠

Risk Factors for Deep Vein Thrombosis after Operations for Fractures

  • Received:2009-10-27 Revised:2009-12-14 Published:2010-06-15 Online:2010-06-15

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摘要： [摘要] 目的 分析影响骨折患者手术治疗后深静脉栓塞(DVT)形成的危险因素.方法 对天津某三甲医院骨科2003年11月到2005年1月入院的515例骨折患者,术后DVT发生情况进行分析.术后7天内采用美国ACUSON128/XP型彩色多普勒超声仪检查患者深静脉血流通畅情况及DVT的发生.对可能与DVT形成有关的25项临床因素进行单因素和多因素Logistic回归分析.结果 男性394例(76.5%),女性121例(23.5%),平均年龄39.89±14.94岁(14岁-79岁),体重指数(BMI)23.74±3.22(15.63-45.52).骨折患者接受手术治疗后,发生DVT的患者有58例(11.3%).经Logistic多因素回归模型分析发现,与DVT形成有关的因素有5个, 凝血酶时间比率、吸烟、体重指数、乳酸脱氢酶和血磷值与术后DVT发生的OR值分别为24.015、2.802、1.113、1.007、0.100(P<0.05).结论 吸烟、体重指数、凝血酶时间比率和乳酸脱氢酶是骨折患者术后发生DVT的危险因素,血磷值是骨折患者术后发生DVT的保护因素.

关键词: 深静脉栓塞, 骨折, 危险因素

Abstract: Abstract Objective To analyze the clinical risk factors for deep vein thrombosis(DVT) after operation for fracture.Methods The data of 515 patients with fracture undergoing operations in a hospital in Tijin between December 2003 and January 2005 were consecutively studied. Color Doppler ultrasonography(American ACUSON128/XP) was used to detect DVT of bilateral lower extremities in all patients in 7 days after operation.25 clinical factors were examined by univariate and multivariate logistic regression analysis in order to analyze their influence on DVT after surgery.Result There were 394 male(76.5%)and 121female(23.5%)patients with a mean age of 40 years,ranging 14-79 years.The prevalence of DVT after surgery was 11.3% among the patients(58/515).Logistic regression analysis demonstrated a definite association of time rate of thrombin,smoking,body mass index, lactic dehydrogenase,phosphorus with odds ratio of24.015, 2.802,1.113, 1.007 and 0.100 respectively(P<0.05).Other clinical factors had no statistical significant association with DVT(P>0.05).Conclusion Smoking,body mass index, time rate of thrombin,lactic dehydrogenase are risk factors for DVT after operatins for fractures while phosphorus is protecting factor for DVT after operatins for fractures.

Key words: Deep vein thrombosis, Fracture, Risk factors