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老年股骨颈骨折后下肢深静脉血栓发生情况及其危险因素分析
刘大伟,朱燕宾,王宇钏,王忠正,金柱成
0
天津南开医院骨科天津 020025;河北医科大学第三医院创伤急救中心石家庄 050051
摘要:
目的:探究老年股骨颈骨折后下肢深静脉血栓的发生率、血栓位置及相关危险因素。方法:回顾性分析天津南开医院和河北医科大学第三医院2017年1月—2019年6月收治的老年股骨颈骨折患者708例。入院后,对患者行常规超声多普勒扫描以评估患者双下肢是否有深静脉血栓,将有血栓者为病例组(112例),无血栓者为对照组(596例)。提取患者的临床资料,包括人口学信息、合并病、受伤情况和入院时实验室结果,采用单因素检验和二元logistic回归分析确定DVT发生的相关危险因素。结果:共112例(15.8%)患者诊断为DVT,84例(75.0%)为远端型,21例(18.8%)为近端型,7例(6.2%)为混合型DVT。75.9%(85/112)的患者DVT发生在骨折侧肢体,12.5%(14/112)发生于双侧肢体,11.6%(13/112)发生于未骨折侧。多因素logistic回归分析显示,年龄大、D-二聚体升高(>0.5 mg/L、受伤至入院时间长、血清白蛋白水平降低(<35 g/L)和血小板计数(>262×109 /L)是发生下肢深静脉血栓的独立危险因素。结论:老年股骨颈骨折患者入院时DVT发生率较高,近端DVT达到6%。多个相关危险因素与DVT独立相关。
关键词:  股骨颈骨折  深静脉血栓  流行病学  危险因素
DOI:10.3969/j.issn.1007-6948.2021.02.012
投稿时间:2020-04-10
基金项目:
Clinical Observation and Analysis of Incidence, Location and Risk Factors of Deep Vein Thrombosis (DVT) in Lower Extremity after Femoral Neck Fracture in the Elderly
LIU Da-wei,ZHU Yan-bin,WANG Yuchuan
Abstract:
Objective To investigate the incidence, location and risk factors of deep venous thrombosis (DVT) in lower extremity after femoral neck fracture in the elderly. Methods A retrospective analysis was performed on elderly patients with femoral neck fractures admitted to Tianjin Nankai Hospital and the Third Hospital of Hebei Medical University from January 2017 to June 2019.After inclusion and exclusion criteria, a total of 708 patients were included in this study. After admission, we performed routine ultrasound doppler scan on the patients to assess whether the patients had deep vein thrombosis in both lower limbs. Patients with thrombosis were selected as the case group and those without thrombosis as the control group. Clinical data of patients were extracted, including demographic information, comorbidities, injury status and laboratory results on admission, and risk factors associated with DVT were determined by single factor test and binary logistic regression analysis. Results A total of 112 (15.8%) patients were diagnosed with DVT, 84 (75.0%) with distal, 21 (18.8%) with proximal, and 7 (6.2%) with mixed DVT. In 75.9% (85/112) of patients, DVT occurred in the fractured limb, 12.5% (14/112) in the bilateral limb, and 11.6% (13/112) in the non-fractured limb. Multivariate logistic regression analysis showed that age (P<0.05), increased d-dimer (>0.5mg/L) (P<0.05), time from injury to admission (P<0.05), decreased serum albumin level (<35g/L) (P<0.05)and platelet count (>262×109/L) (P<0.05) were independent related factors for the development of DVT in lower extremity. Conclusion The results of this study suggest that the incidence of DVT is higher in the elderly patients with femoral neck fracture upon admission, with proximal DVT reaching 6%.Several related risk factors are independently related to DVT, which can help predict the occurrence of thrombosis,
Key words:  Femoral neck fracture  deep vein thrombosis  epidemiology  risk factors

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