[1]刘月星,杨朝昕,万 乾,等.老年髋部骨折术前健侧肢体深静脉血栓形成的危险因素分析[J].医学信息,2020,33(10):108-110.[doi:10.3969/j.issn.1006-1959.2020.10.028]
　LIU Yue-xing,YANG Zhao-xin,WAN Qian,et al.Analysis of Risk Factors for Deep Venous Thrombosis in the Healthy Limbs of the Elderly before Hip Fracture[J].Medical Information,2020,33(10):108-110.[doi:10.3969/j.issn.1006-1959.2020.10.028]
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老年髋部骨折术前健侧肢体深静脉血栓形成的危险因素分析()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
33卷
期数:
2020年10期
页码:
108-110
栏目:
临床研究
出版日期:
2020-05-15

文章信息/Info

Title:
Analysis of Risk Factors for Deep Venous Thrombosis in the Healthy Limbs of the Elderly before Hip Fracture
文章编号:
1006-1959（2020）10-0108-03
作者:
刘月星; 杨朝昕; 万 乾; 等
（承德医学院附属医院创伤骨科，河北 承德 067000）
Author(s):
LIU Yue-xing; YANG Zhao-xin; WAN Qian; et al
(Department of Traumatology and Orthopedics,the Affiliated Hospital of Chengde Medical College,Chengde 067000,Hebei,China)
关键词:
髋部骨折; 老年; 健侧肢体; 深静脉血栓; 危险因素
Keywords:
Hip fracture; Old age; Healthy limb; Deep vein thrombosis; Risk factors
分类号:
R687.3；R543.6
DOI:
10.3969/j.issn.1006-1959.2020.10.028
文献标志码:
A
摘要:
目的 探讨老年髋部骨折患者术前健侧肢体深静脉血栓（DVT）形成的发生率及相关影响因素。方法 回顾性分析2018年1月1日~12月31日承德医学院附属医院创伤骨科收治的168例老年髋部骨折患者的临床资料，术前均行双下肢静脉多普勒超声检查，根据超声检查结果分为DVT组和非DVT组，其中DVT组21例，非DVT组147例；住院期间给予低分子肝素钙预防抗凝，以性别、年龄、合并内科疾病、受伤至观察时间、血浆白蛋白、纤维蛋白原为变量，分析患者术前发生DVT的危险因素。结果 共168例患者在住院期间行下肢静脉多普勒超声检查，其中有147例（87.50%）双下肢未发生DVT，21例（12.50%）健侧肢体发生DVT。在21例健侧肢体发生血栓的患者中，有9例（42.86%）仅发生在健侧肢体，患侧肢体无血栓形成。DVT组受伤等待的时间大于非DVT组（P＜0.05）；高血压、冠心病、糖尿病的患病率高于非DVT组（P＜0.05），且在血栓形成高峰期DVT血浆白蛋白明显低于非DVT组（P＜0.05）,纤维蛋白原高于非DVT组（P＜0.05）。多因素分析结果显示，受伤平均等待时间、糖尿病、血浆白蛋白、纤维蛋白原是下肢骨折后健侧肢体DVT形成的独立危险因素（P＜0.05）。结论 针对老年髋部骨折患者，尽管给与低分子肝素钙进行预防，但术前健侧肢体深静脉血栓仍有发生，应该引起临床医生的足够重视，术前均应行双下肢静脉多普勒超声检查；并且对于手术等待时间长、纤维蛋白原过高、血浆白蛋白过低同时合并糖尿病患者应特别警惕下肢DVT的发生。
Abstract:
Objective To investigate the incidence and related influencing factors of the formation of deep vein thrombosis (DVT) of the healthy limbs in elderly patients with hip fractures. Methods The clinical data of 168 elderly patients with hip fractures admitted to the Department of Traumatology and Orthopedics of the Affiliated Hospital of Chengde Medical College from January 1 to December 31, 2018 were retrospectively analyzed. All patients were examined by doppler ultrasonography of the lower extremity vein before surgery. The examination results were divided into DVT group and non-DVT group, including 21 cases in DVT group and 147 cases in non-DVT group; low molecular weight heparin calcium was given to prevent anticoagulation during hospitalization, based on gender, age, medical disease, injury to observation time, plasma white protein and fibrinogen were variables, and the risk factors of patients with DVT before operation were analyzed.Results A total of 168 patients underwent venous Doppler ultrasonography during hospitalization. Among them, 147 (87.50%) had no DVT in both lower extremities, and 21 (12.50%) had DVT on the contralateral limb. Of the 21 patients with thrombosis on the contralateral limb, 9 (42.86%) occurred only on the contralateral limb, and no thrombosis occurred on the affected limb. The waiting time for injury in the DVT group was longer than that in the non-DVT group(P<0.05); the prevalence of hypertension, coronary heart disease, and diabetes was higher than that in the non-DVT group(P<0.05), and DVT plasma albumin was significantly lower at the peak of thrombosis In the non-DVT group(P<0.05), fibrinogen was higher than that in the non-DVT group(P<0.05). The results of multivariate analysis showed that the average waiting time for injury, diabetes, plasma albumin, and fibrinogen were independent risk factors for the formation of DVT in the healthy limb after lower limb fracture(P<0.05).Conclusion For elderly patients with hip fractures, although low molecular weight heparin calcium is given for prevention, deep vein thrombosis of the healthy limbs still occurs before surgery, and should be paid enough attention by clinicians. Both lower limb vein Doppler should be performed before surgery Ultrasound examination; and for patients with long waiting time for surgery, high fibrinogen, low plasma albumin and diabetic patients with diabetes, special attention should be paid to the occurrence of lower limb DVT.

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更新日期/Last Update: 2020-05-15