Department of Orthopaedic Surgery, The Affiliated Taizhou People's Hospital of Nantong University, Taizhou, China.
Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, China.
Clin Appl Thromb Hemost. 2018 Dec;24(9_suppl):157S-162S. doi: 10.1177/1076029618798940. Epub 2018 Sep 10.
Lower limb deep vein thrombosis (DVT) is not an uncommon postoperative complication of spinal fusion surgery. However, the related risk factors identified in previous studies remain controversial. This study aimed to investigate risk factors for lower limb DVT in patients with single-level lumbar fusion surgery. Between January 2010 and December 2016, a total of 710 patients undergoing lumbar fusion were recruited for this study, including 172 males and 538 females (aged 18-75 years). Deep vein thrombosis was detected by ultrasonography. Accordingly, patients were divided into the DVT group and the non-DVT group and compared in terms of operative data, underlying diseases, and biochemical data. Additionally, logistic regression analysis was performed to identify risk factors for lower limb DVT. The incidence of lower limb DVT was 11.8% (84 of 710 cases). Five patients were symptomatic, with lower limb pain and swelling. Two patients developed pulmonary embolism and 1 died. Binary logistic regression indicated that advanced age ( = .001, odds ratio [OR] = 2.86, 95% CI: 1.85-5.12), hypertension ( = .006, OR = 4.10, 95% CI: 1.09-2.30), and increased d-dimer ( < .001, OR = 3.49, 95% CI: 2.05-6.36) were risk factors for postoperative DVT. In conclusion, for patients with single-level lumbar fusion, advanced age, increased d-dimer, and hypertension may contribute to DVT development after spinal fusion surgery. Therefore, patients with these risk factors should be protected during the perioperative period.
下肢深静脉血栓(DVT)是脊柱融合手术后一种常见的术后并发症。然而,既往研究中确定的相关危险因素仍存在争议。本研究旨在探讨单节段腰椎融合术后下肢 DVT 的危险因素。
2010 年 1 月至 2016 年 12 月,共招募了 710 例接受腰椎融合术的患者进行本研究,其中男 172 例,女 538 例(年龄 18-75 岁)。通过超声检查检测深静脉血栓。因此,将患者分为 DVT 组和非 DVT 组,并比较手术数据、基础疾病和生化数据。此外,进行逻辑回归分析以确定下肢 DVT 的危险因素。
下肢 DVT 的发生率为 11.8%(710 例中有 84 例)。5 例患者出现下肢疼痛和肿胀等症状。2 例发生肺栓塞,1 例死亡。二元逻辑回归表明,高龄( =.001,优势比[OR] = 2.86,95%可信区间:1.85-5.12)、高血压( =.006,OR = 4.10,95%可信区间:1.09-2.30)和 d-二聚体升高( <.001,OR = 3.49,95%可信区间:2.05-6.36)是术后 DVT 的危险因素。
综上所述,对于单节段腰椎融合术患者,高龄、d-二聚体升高和高血压可能导致脊柱融合术后 DVT 的发生。因此,具有这些危险因素的患者应在围手术期得到保护。