| 孙健平,薛汉中,王鹏飞,等.髋部骨折术前双下肢深静脉血栓发生率及其危险因素分析.骨科,2018,9(6): 464-468. |
| 髋部骨折术前双下肢深静脉血栓发生率及其危险因素分析 |
| Incidence and risk factors of deep venous thrombosis of the bilateral extremities in patients with hip fracture before operation |
| 投稿时间：2018-06-08 |
| DOI：DOI：10.3969/j.issn.1674-8573.2018.06.009 |
| 中文关键词: 髋骨折 发生率 危险因素 |
| 英文关键词: Hip fractures Incidence Risk factors |
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| 中文摘要: |
| 目的 探讨髋部骨折术前双下肢深静脉血栓形成（deep vein thrombosis, DVT）的发生率及其危险因素。方法 回顾性分析2014年9月至2017年10月西安红会医院收治的997例髋部骨折病人资料，男382例，女615例；平均年龄为72.3（17~102）岁。其中股骨颈骨折493例，股骨转子间骨折470例，股骨转子下骨折34例。根据术前双下肢静脉彩超结果分为双下肢血栓组、非双下肢血栓组。对年龄、性别、骨折类型、受伤至手术的时间、术前的实验室检查（血红蛋白、红细胞比容、纤维蛋白原、D-二聚体）、合并内科疾病（原发性高血压、糖尿病、冠状动脉粥样硬化性心脏病、合并两种以上的内科疾病、无内科疾病）等可能危险因素进行单因素分析，再采用多因素Logistic回归分析确定其独立危险因素。结果 997例髋部骨折病人中66例（6.62%）术前发生双下肢DVT。双下肢血栓组与非双下肢血栓组病人的性别、骨折类型、术前D-二聚体水平、术前纤维蛋白原水平、合并内科疾病比较，差异均无统计学意义（P均＞0.05）；而两组病人年龄、受伤至手术时间、术前血红蛋白水平、术前红细胞比容比较，差异均有统计学意义（P均＜0.05）。多因素Logistic回归分析结果显示：年龄＞60岁［95%CI（1.153，12.367），P=0.028］、受伤至手术时间＞7 d［95%CI（1.087，3.178），P=0.023］为髋部骨折术前双下肢DVT的独立危险因素。结论 髋部骨折术前双下肢DVT的发生率约为6.62%；病人的年龄＞60岁、受伤至手术时间＞7 d是髋部骨折术前双下肢DVT的独立危险因素。 |
| 英文摘要: |
| Objective To investigate the incidence and risk factors of the bilateral deep vein thrombosis (DVT) in the patients with hip fractures before operation. Methods The data of 997 patients with hip fracture admitted in Xi'an Honghui Hospital from September 2014 to October 2017 were retrospectively analyzed. There were 382 males and 615 females, with a mean age of 72.3 years (17-102 years). The preoperative diagnosis was femoral neck fracture in 493 patients, intertrochanteric fracture in 470 patients, and subtrochanteric fracture in 34 patients. The patients were divided into bilateral lower limb thrombosis group and non-bilateral lower limb thrombosis group according to preoperative double lower extremity venous ultrasonography results. The patient's age, gender, type of fracture, time from injury to surgery, preoperative laboratory tests (hemoglobin, hematocrit, fibrinogen, D-dimer), concurrent internal medical diseases (primary hypertension, diabetes, coronary atherosclerotic heart disease, combined with more than two kinds of internal medical diseases, no internal medical diseases) were statistically analyzed. First, single factor analysis was used to screen risk factors, and then multiple factor Logistic regression analysis was used to determine the independent risk factors. Results In 997 patients with hip fracture, 66 patients (6.62%) had bilateral lower limbs DVT before operation. There was no significant difference in gender, fracture type, preoperative D-dimer level, preoperative fibrinogen level and complication of internal medicine between bilateral lower limb thrombosis group and non-bilateral lower limb thrombosis group (P＞0.05). There were significant differences in age, time from injury to surgery, preoperative hematocrit level and preoperative hemoglobin level between the two groups (P＜0.05). Multivariate Logistic regression analysis showed that age ＞60 years old ［95%CI (1.153, 12.367), P=0.028］, and interval of ＞7 days from injury to surgery ［95%CI (1.087, 3.178), P=0.023］ were independent risk factors for DVT of the bilateral extremities in patients with hip fracture before operation. Conclusion Incidence of DVT of the bilateral extremities in patients with hip fracture before operation was 6.62%. Multivariate Logistic regression analysis showed that age ＞60 years old, interval of ＞7 days from injury to surgery were independent risk factors for DVT of the bilateral extremities in patients with hip fracture before operation. |
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