1 Department of Orthopedics and Traumatology, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
2 Department of Orthopaedic Surgery, University of California, San Francisco, CA, USA.
Clin Appl Thromb Hemost. 2019 Jan-Dec;25:1076029619845066. doi: 10.1177/1076029619845066.
This study aimed to investigate the incidence and risk factors for deep vein thrombosis (DVT) in patients with pelvic and acetabular fractures. Patients with pelvic or acetabular fractures were included. Demographic data, fracture classification, time to surgery, and d-dimer levels at admission and one day after surgical intervention were recorded. Duplex ultrasonography was performed in the lower extremities for DVT evaluation. All patients received mechanical and chemical thromboprophylaxis. One hundred ten patients with a mean age of 44.2 ± 13.8 years were included. There were 48 patients with pelvic fractures and 62 patients with acetabular fractures. Thirty-two (29.09%) patients sustained DVT; 21 (19.09%) patients exhibited proximal thrombosis, and 3 patients suffered pulmonary embolism. The incidence of DVT in patients with acetabular fractures was significantly higher than that of patients with pelvic fractures (χ = 4.42, P = .04). The incidence of proximal DVT was significantly higher in patients with complex acetabular fractures than in patients with simple acetabular fractures (χ = 6.65, P = .01). Multivariate analysis showed that age older than 60 years, associated injuries, and the time to surgery longer than 2 weeks were independent risk factors ( P < .05). Despite mechanical and chemical thromboprophylaxis, the risk of DVT in patients with pelvic and acetabular fractures is still very high, and most of the thromboses were localized proximally. The risk of DVT is higher in patients older than 60 years, in those with associated injuries, and when the time from injury to operation is more than 2 weeks.
本研究旨在探讨骨盆和髋臼骨折患者深静脉血栓形成（DVT）的发生率和危险因素。纳入骨盆或髋臼骨折患者。记录人口统计学数据、骨折分类、手术时间以及入院时和手术干预后一天的 D-二聚体水平。下肢行双功超声检查评估 DVT。所有患者均接受机械和化学血栓预防。共纳入 110 例患者，平均年龄 44.2±13.8 岁。48 例为骨盆骨折，62 例为髋臼骨折。32 例（29.09%）患者发生 DVT；21 例（19.09%）患者为近端血栓形成，3 例患者发生肺栓塞。髋臼骨折患者 DVT 的发生率明显高于骨盆骨折患者（χ=4.42，P=0.04）。复杂髋臼骨折患者近端 DVT 的发生率明显高于简单髋臼骨折患者（χ=6.65，P=0.01）。多因素分析显示，年龄大于 60 岁、合并损伤以及手术时间大于 2 周是独立的危险因素（P＜0.05）。尽管进行了机械和化学血栓预防，骨盆和髋臼骨折患者仍存在很高的 DVT 风险，且大多数血栓位于近端。60 岁以上、合并损伤以及受伤至手术时间超过 2 周的患者 DVT 风险更高。
