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中国神经外科患者下肢深静脉血栓形成的临床特征及危险因素分析

Clinical features and risk factor analysis for lower extremity deep venous thrombosis in Chinese neurosurgical patients.

作者信息

Guo Fuyou, Shashikiran Tagilapalli, Chen Xi, Yang Lei, Liu Xianzhi, Song Laijun

机构信息

Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, PR China.

出版信息

J Neurosci Rural Pract. 2015 Oct-Dec;6(4):471-6. doi: 10.4103/0976-3147.169801.

Abstract

BACKGROUND

Deep venous thrombosis (DVT) contributes significantly to the morbidity and mortality of neurosurgical patients; however, no data regarding lower extremity DVT in postoperative Chinese neurosurgical patients have been reported.

MATERIALS AND METHODS

From January 2012 to December 2013, 196 patients without preoperative DVT who underwent neurosurgical operations were evaluated by color Doppler ultrasonography and D-dimer level measurements on the 3(rd), 7(th), and 14(th) days after surgery. Follow-up clinical data were recorded to determine the incidence of lower extremity DVT in postoperative neurosurgical patients and to analyze related clinical features. First, a single factor analysis, Chi-square test, was used to select statistically significant factors. Then, a multivariate analysis, binary logistic regression analysis, was used to determine risk factors for lower extremity DVT in postoperative neurosurgical patients.

RESULTS

Lower extremity DVT occurred in 61 patients, and the incidence of DVT was 31.1% in the enrolled Chinese neurosurgical patients. The common symptoms of DVT were limb swelling and lower extremity pain as well as increased soft tissue tension. The common sites of venous involvement were the calf muscle and peroneal and posterior tibial veins. The single factor analysis showed statistically significant differences in DVT risk factors, including age, hypertension, smoking status, operation time, a bedridden or paralyzed state, the presence of a tumor, postoperative dehydration, and glucocorticoid treatment, between the two groups (P < 0.05). The binary logistic regression analysis showed that an age greater than 50 years, hypertension, a bedridden or paralyzed state, the presence of a tumor, and postoperative dehydration were risk factors for lower extremity DVT in postoperative neurosurgical patients.

CONCLUSIONS

Lower extremity DVT was a common complication following craniotomy in the enrolled Chinese neurosurgical patients. Multiple factors were identified as predictive of DVT in neurosurgical patients, including the presence of a tumor, an age greater than 50 years, hypertension, and immobility.

摘要

背景

深静脉血栓形成(DVT)是导致神经外科患者发病和死亡的重要原因;然而,目前尚无关于中国神经外科术后患者下肢深静脉血栓形成的相关数据报道。

材料与方法

选取2012年1月至2013年12月期间196例术前无深静脉血栓形成且接受神经外科手术的患者,于术后第3天、第7天和第14天通过彩色多普勒超声检查及D - 二聚体水平测定进行评估。记录随访临床数据,以确定神经外科术后患者下肢深静脉血栓形成的发生率并分析相关临床特征。首先,采用单因素分析(卡方检验)筛选具有统计学意义的因素。然后,采用多因素分析(二元逻辑回归分析)确定神经外科术后患者下肢深静脉血栓形成的危险因素。

结果

61例患者发生下肢深静脉血栓形成,纳入研究的中国神经外科患者深静脉血栓形成发生率为31.1%。深静脉血栓形成的常见症状为肢体肿胀、下肢疼痛以及软组织张力增加。静脉受累的常见部位为小腿肌肉、腓静脉和胫后静脉。单因素分析显示,两组之间在深静脉血栓形成危险因素方面存在统计学显著差异,包括年龄、高血压、吸烟状况、手术时间、卧床或瘫痪状态、肿瘤存在情况、术后脱水以及糖皮质激素治疗(P < 0.05)。二元逻辑回归分析显示,年龄大于50岁、高血压、卧床或瘫痪状态、肿瘤存在情况以及术后脱水是神经外科术后患者下肢深静脉血栓形成的危险因素。

结论

下肢深静脉血栓形成是纳入研究的中国神经外科患者开颅术后的常见并发症。多种因素被确定为神经外科患者深静脉血栓形成的预测因素,包括肿瘤存在情况、年龄大于50岁、高血压和活动受限。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e787/4692000/b6f23bbec60e/JNRP-6-471-g002.jpg

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