Zhang W, Zhang J F, Wang M, Cao X H, Wang L J, Niu X H, Huang H J, Qiu N N
Department of Interventional Radiology, First People's Hospital of Zhengzhou, Zhengzhou 450004, China.
Department of Orthopedics, First People's Hospital of Zhengzhou, Zhengzhou 450004, China.
Zhonghua Yi Xue Za Zhi. 2020 Feb 4;100(4):291-294. doi: 10.3760/cma.j.issn.0376-2491.2020.04.010.
To investigate the incidence and risk factors of lower extremities deep venous thrombosis (DVT) in patients with chronic refractory wounds (chronic wounds). A retrospective analysis of 722 cases of chronic wounds admitted to the First People's Hospital of Zhengzhou from January 1, 2015 to December 31, 2018 was carried out, and clinical data such as gender, age, wound involves the lower extremities, wound type, duration of wound, D-dimer level and complicated diabetes, hypertension, coronary heart disease, cerebral infarction, pneumonia and sepsis/septic shock were collected. The patients were divided into DVT group and non-DVT group according to the color ultrasound test. Multivariate binary logistic regression analysis was used to screen the independent risk factors of DVT in patients with chronic wounds. There were 55 (7.6%) patients in DVT group, of which 44(80.0%) were diagnosed as chronic DVT by conventional lower extremities venous color ultrasound screening at admission, and the remaining 11(20.0%) were newly diagnosed during hospitalization. There were no significant differences in gender, wound involves the lower extremities, duration of wound, complicated diabetes and hypertension between DVT group and non-DVT group (all 0.05); and the differences were statistically significant in age, wound type, D-dimer level, complicated coronary heart disease, cerebral infarction, pneumonia and sepsis/septic shock (all 0.05). Multivariate binary logistic regression analysis showed age [2.260 (95: 1.584-3.224)], D-dimer level [14.201 (95: 6.101-33.055)], complicated coronary heart disease [2.731 (95: 1.210-6.162)] and sepsis/septic shock [3.170 (95: 1.115-9.016)] were independent risk factors for DVT (all 0.05). Chronic wounds patients have a higher incidence of DVT, most of which are chronic DVT, and age, D-dimer level, complicated coronary heart disease and sepsis/septic shock are independent risk factors for DVT in chronic wounds.
探讨慢性难愈性伤口(慢性伤口)患者下肢深静脉血栓形成(DVT)的发生率及危险因素。对2015年1月1日至2018年12月31日在郑州市第一人民医院收治的722例慢性伤口患者进行回顾性分析,收集性别、年龄、伤口累及下肢情况、伤口类型、伤口持续时间、D-二聚体水平以及合并糖尿病、高血压、冠心病、脑梗死、肺炎和脓毒症/脓毒性休克等临床资料。根据彩色超声检查结果将患者分为DVT组和非DVT组。采用多因素二元logistic回归分析筛选慢性伤口患者DVT的独立危险因素。DVT组有55例(7.6%)患者,其中44例(80.0%)在入院时通过常规下肢静脉彩色超声筛查诊断为慢性DVT,其余11例(20.0%)在住院期间新诊断。DVT组与非DVT组在性别、伤口累及下肢情况、伤口持续时间、合并糖尿病和高血压方面差异均无统计学意义(均P>0.05);在年龄、伤口类型、D-二聚体水平、合并冠心病、脑梗死、肺炎和脓毒症/脓毒性休克方面差异有统计学意义(均P<0.05)。多因素二元logistic回归分析显示年龄[2.260(95%CI:1.584 - 3.224)]、D-二聚体水平[14.201(95%CI:6.101 - 33.055)]、合并冠心病[2.731(95%CI:1.210 - 6.162)]和脓毒症/脓毒性休克[3.170(95%CI:1.115 - 9.016)]是DVT的独立危险因素(均P<0.05)。慢性伤口患者DVT发生率较高,多数为慢性DVT,年龄、D-二聚体水平、合并冠心病和脓毒症/脓毒性休克是慢性伤口患者DVT的独立危险因素。