摘要
目的探讨红细胞分布宽度(red blood cell distribution width,RDW)/血小板计数(platelet,PLT)比值(red blood cell distribution width to platelet ratio,RPR)对重症颅脑损伤(severe traumatic brain injury,sTBI)患者围手术期深静脉血栓(deep venous thrombosis,DVT)的评估价值。方法回顾2021年6月至2024年6月邢台市中心医院神经内科收治的sTBI患者116例作为研究对象,根据围手术期是否发生DVT将患者分为DVT组(n=24)和未DVT组(n=92)。记录所有sTBI患者入院时的RDW、PLT并计算RPR。绘制受试者工作特征曲线(receiver operating characteristic,ROC)分析RDW、PLT及RPR评估sTBI患者围手术期DVT的效能,采用二分类Logistic逐步回归分析探讨sTBI患者围手术期DVT的影响因素。结果DVT组患者RDW、RPR水平均高于未DVT组,PLT低于未DVT组,差异有统计学意义(P<0.05)。ROC结果显示,RDW、PLT及RPR评估sTBI患者围手术期发生DVT的AUC(95%CI)分别为0.829(0.784~0.879)、0.735(0.690~0.780),0.911(0.861~0.961),RPR评估sTBI患者围手术期发生DVT的AUC优于RDW、PLT评估的AUC(Z=8.429,P<0.01;Z=12.190,P<0.01)。DVT组有多发伤、受伤至手术时间≥5 d、肺部感染、高血糖、高血压及术中失血量高于未DVT组,术中输血量低于未DVT组,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,受伤至手术时间≥5 d(OR=2.408,95%CI:1.380~4.202)、肺部感染(OR=1.865,95%CI:1.116~3.116)、高血糖(OR=2.109,95%CI:1.240~3.586)、RPR≥0.06(OR=3.304,95%CI:1.813~6.018)是sTBI患者围手术期DVT的影响因素(P<0.05)。结论重症颅脑损伤患者的RPR值与围手术期深静脉血栓的发生密切相关,是预后评估的重要参考指标,可为临床评估提供参考。
Objective To explore the value of red cell distribution width(RDW)/platelet count(PLT)ratio(RPR)in the assessment of deep vein thrombosis(DVT)in patients with severe traumatic brain injury(sTBI)during the perioperative period.Methods A total of 116 patients with sTBI from June 2021 to June 2024 were retrospectively enrolled as the research subjects.Among them,24 patients with DVT during the perioperative period were assigned to the DVT group,and the remaining 92 patients with sTBI were assigned to the non-DVT group.The RDW and PLT of all sTBI patients at admission were recorded,and their RPR was calculated.The efficacy of RDW,PLT,and RPR in evaluating DVT in sTBI patients during the perioperative period was analyzed by ROC.The influencing factors of DVT in sTBI patients during the perioperative period were explored by Binary Logistic stepwise regression analysis.Results The levels of RDW and RPR in the DVT group were higher than those in the nonDVT group,whereas their PLT was lower(P<0.05).ROC results showed that the AUC(95%CI)of RDW,PLT,and RPR in evaluating DVT in sTBI patients during the perioperative period were 0.829(0.784-0.879),0.735(0.690-0.780),and 0.911(0.861-0.961)respectively.The AUC of RPR in evaluating DVT in sTBI patients during the perioperative period was superior to that of RDW and PLT(Z=8.429,P<0.01;Z=12.190,P<0.01).The DVT group had a higher proportion of patients with multiple injuries,injury-to-surgery time≥5 days,pulmonary infection,hyperglycemia,hypertension,and intraoperative blood loss,and a lower intraoperative blood transfusion volume than the non-DVT group(P<0.05).Injury-to-surgery time≥5 days(OR=2.408,95%CI:1.380-4.202),pulmonary infection(OR=1.865,95%CI:1.116-3.116),hyperglycemia(OR=2.109,95%CI:1.240-3.586),and RPR≥0.06(OR=3.304,95%CI:1.813-6.018)were the influencing factors of DVT in sTBI patients during the perioperative period(P<0.05).Conclusions The RPR value of patients with severe traumatic brain injury is closely related to the occurrence of deep vein thrombosis during the perioperative period,which is an important reference index for prognosis assessment and can provide a basis for clinical assessment.
作者
陈玉涛
张惠
韩海霞
霍旭宁
刘秀君
张卫民
CHEN Yutao;ZHANG Hui;HAN Haixia;HUO Xuning;LIU Xiujun;ZHANG Weimin(Department of Neurology,Xingtai Central Hospital/Affiliated Hospital of Xingtai Medical College,Xingtai,Hebei 054000,China;Department of Neurosurgery,Xingtai Central Hospital/Affiliated Hospital of Xingtai Medical College,Xingtai,Hebei 054000,China)
出处
《中华神经外科疾病研究杂志》
2025年第3期81-86,共6页
Chinese Journal of Neurosurgical Disease Research
基金
河北省医学科学研究重点课题项目(20181615)
邢台市重点研发计划自筹项目(2020ZC349)。
关键词
重症颅脑损伤
围手术期
深静脉血栓
红细胞分布宽度/血小板计数比值
Severe traumatic brain injury
Perioperative period
Deep vein thrombosis
Red cell distribution Width/platelet count ratio
