腰椎融合术后早期下肢深静脉血栓形成的相关危险因素分析

Risk factors for early lower extremity deep venous thrombosis after posterior lumbar interbody fusion

中文关键词:  腰椎融合术  早期  下肢深静脉血栓  危险因素

英文关键词:Posterior lumbar interbody fusion  Early  Lower extremity deep venous thrombosis  Risk factors

中文摘要:

  【摘要】 目的：探讨腰椎融合术后早期下肢深静脉血栓（deep venous thrombosis，DVT）形成的危险因素。方法：选取于2015年7月～2017年5月在广西壮族自治区人民医院骨科接受腰椎后路椎间融合术治疗的患者共165例，依据术后早期超声检查结果双下肢有无血栓形成，分为DVT组和非DVT组。对比两组患者的性别、年龄、体重指数、糖尿病、高血压病、术前凝血四项、D-二聚体、融合节段数、手术时间、术中输血、术后使用抗凝药、术后卧床时间等指标，再采用Logistic多因素回归分析进行统计学分析。结果：共纳入165例患者，术后并发下肢DVT者24例，发生率为14.5%。与非DVT组相比较，单因素χ2检验显示两组在年龄、体重指数、手术时间、术中输血、术后卧床时间等指标差异具有统计学意义。多因素Logistic回归分析显示，年龄≥60岁（OR=6.444，95%CI=2.116～19.628）、体重指数≥24kg/m2（OR=4.463，95%CI=1.603～12.426）、术中输血（OR=3.484，95%CI=1.110～10.932）、术后卧床天数≥5d（OR=3.155，95%CI=1.027～9.695）是腰椎融合术后早期并发下肢DVT的独立危险因素。结论：年龄≥60岁、体重指数≥24kg/m2、术中输血、术后卧床天数≥5d的患者腰椎融合术后早期易出现下肢DVT形成。

英文摘要:

  【Abstract】 Objectives: To investigate and analyze the risk factors of early lower extremity deep vein thrombosis after posterior lumbar interbody fusion. Methods: A total of 165 patients undergoing spinal fusion surgery in the Guangxi Zhuang Autonomous Region People′s Hospital from July 2015 to May 2017 were collected. Type-B ultrasonic was perforemed on lower extremities before and after surgery. According to the results of ultrasonography after surgery, these cases were divided into two groups, DVT group and non DVT group. Age, gender, BMI, diabetes, hypertension, blood clotting function, D-dimer, fusion segments, operation time, blood transfusion, anticoagulants, postoperative bed time were recorded. Chi square test was used to analyze the risk factors of early deep vein thrombosis after posterior lumbar interbody fusion, and multivariate logistic regression analysis was applied to explore the main risk factors of DVT. Results: The incidence of DVT after posterior lumbar interbody fusion was 14.5%(24 of 165 cases). Single-factor analysis showed that there were significant differences between the two groups in age, body mass index(BMI), operation time, blood transfusion and postoperative bed time. Multivariate logistic regression analysis showed age≥60(OR=6.444, 95% CI=2.116-19.628), BMI≥24kg/m2(OR=4.463, 95% CI=1.603-12.426), blood transfusion(OR=3.484, 95% CI=1.110-10.932), postoperative bed time≥5 days(OR=3.155, 95% CI=1.027-9.695) were risk factors associated with occurrence of DVT after posterior lumbar interbody fusion. Conclusions: Aged≥60, BMI≥24kg/m2, blood transfusion and postoperative bed time ≥5 days are more likely to have early lower extremity deep vein thrombosis after posterior lumbar interbody fusion.