摘要
目的探讨重型颅脑损伤患者术后下肢深静脉血栓(DVT)形成的相关危险因素。方法收集2021年6月至2023年5月于南京医科大学第一附属医院(江苏省人民医院)住院接受手术治疗的217例重型颅脑损伤患者的临床资料,按照住院期间是否发生下肢DVT将患者分为血栓组(n=29)和对照组(n=188)。收集所有患者入院时的基本信息、住院期间手术及主要治疗相关信息。比较两组患者的临床特征,住院期间手术情况、药物治疗情况及住院结局,采用多因素Logistic回归模型分析重型颅脑损伤患者术后下肢DVT形成的危险因素。结果血栓组患者的年龄大于对照组患者,合并下肢骨折的比例、使用机械通气的比例均高于对照组患者,术后住院期间昏迷时间长于对照组患者,差异均有统计学意义(P﹤0.05)。多因素分析结果显示,老年(年龄≥60岁)、术后住院期间昏迷时间≥4天、合并下肢骨折及使用机械通气均是重型颅脑损伤患者术后下肢DVT形成的独立危险因素(P﹤0.05)。结论年龄、术后住院期间昏迷时间、下肢骨折情况及使用机械通气情况均与重型颅脑损伤患者术后下肢DVT的形成密切相关,临床中应针对此类患者强化预防下肢DVT的措施,并做好观察,及时发现下肢DVT。
Objective To investigate the risk factors of postoperative lower extremity deep vein thrombosis(DVT)in patients with severe traumatic brain injury.Method Clinical data of 217 patients with severe traumatic brain injury who were hospitalized for surgical treatment at the First Affiliated Hospital with Nanjing Medical University(Jiangsu Province Hospital)from June 2021 to May 2023 were collected.The patients were divided into thrombotic group(n=29)and control group(n=188)based on whether lower extremity DVT occurred during hospitalization.The basic information of all patients upon admission,as well as information related to surgery and major treatments during hospitalization were collected.The clinical characteristics,surgical outcomes,medication treatment,and hospitalization outcomes between two groups of patients during hospitalization were compared.The risk factors for postoperative lower extremity DVT formation in patients with severe traumatic brain injury were analyzed by multivariate Logistic regression model.Result The age of patients in the thrombotic group was older than that in the control group,the proportion of lower extremity fractures and the proportion of patients using mechanical ventilation were higher than those in the control group,the comatose time during postoperative hospitalization was longer than that in the control group,the differences were statistically significant(P<0.05).The results of multivariate analysis showed that elderly(age≥60 years),comatose time during postoperative hospitalization≥4 d,combined lower extremity fractures,and mechanical ventilation were all independent risk factors for the formation of lower extremity DVT in patients with severe traumatic brain injury(P<0.05).Conclusion Age,comatose time during postoperative hospitalization,lower extremity fractures,and use of mechanical ventilation are closely related to the formation of lower extremity DVT in patients with severe traumatic brain injury.In clinical practice,measures should be strengthened to prevent lower extremity DVT in such patients,and observation should be carried out to detect lower extremity DVT in a timely manner.
作者
张程
许彬
李娜
张婷
孙雪娟
李征
Zhang Cheng;Xu Bin;Li Na;Zhang Ting;Sun Xuejuan;Li Zheng(Neurosurgery ICU,the First Affiliated Hospital with Nanjing Medical University(Jiangsu Province Hospital),Nanjing 210029,Jiangsu,China;Neurosurgical Cerebrovascular Intervention Group,the First Affiliated Hospital with Nanjing Medical University(Jiangsu Province Hospital),Nanjing 210029,Jiangsu,China)
出处
《血管与腔内血管外科杂志》
2024年第4期476-480,共5页
Journal of Vascular and Endovascular Surgery
基金
江苏省研究型医院学会脑血管病血流动力学专项科研基金项目(JY202302)。
关键词
重型颅脑损伤
下肢
深静脉血栓
危险因素
severe brain injury
lower extremity
deep vein thrombosis
risk factor
