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术前下肢踝关节骨折后深静脉血栓(DVT)的发生率和位置。

Preoperative incidence and locations of deep venous thrombosis (DVT) of lower extremity following ankle fractures.

机构信息

Department of Foot and Ankle Surgery, The 3rd Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, People's Republic of China.

Department of Orthopaedic Surgery, The 3rd Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, People's Republic of China.

出版信息

Sci Rep. 2020 Jun 24;10(1):10266. doi: 10.1038/s41598-020-67365-z.

Abstract

This retrospective study aimed to investigate the preoperative incidence and locations of deep venous thrombosis (DVT) in patients undergoing surgeries for ankle fractures and identify the associated risk factors. From January 2016 to June 2019, 1,532 patients undergoing surgery of ankle fractures were included. Their inpatient medical records were inquired for data collection, including demographics, comorbidities, injury-related data and preoperative laboratory biomarkers. DVT of bilateral lower extremities was diagnosed by routine preoperative Doppler examination. Univariate analyses and multivariate logistic regression analyses were used to identify the independent risk factors. Totally, 98 patients had a preoperative DVT, indicating an incidence rate of 6.4%. A total of 164 clots for 6 veins were found, representing an average of 1.7 for each patient. The detailed DVTs involving veins were as follows: 2 in femoral common vein, 7 in superficial femoral vein, 2 in deep femoral vein, 16 in popliteal vein, 49 in posterior tibial vein, and 88 in peroneal vein. In the multivariate model, 5 risk factors were identified to be associated with DVT, including age (10-year increase), gender, lower ALB level, reduced LYM count and elevated D-dimer level. There was a tendency for diabetes mellitus to increase the risk of DVT, although there was no statistical significance (p = 0.063). These epidemiologic data on DVT may help counsel patients about the risk of DVT, individualized risk assessment and accordingly the risk stratification.

摘要

本回顾性研究旨在探讨踝关节骨折手术患者术前深静脉血栓形成(DVT)的发生率和部位,并确定相关的危险因素。2016 年 1 月至 2019 年 6 月,共纳入 1532 例行踝关节骨折手术的患者。查阅他们的住院病历以进行数据收集,包括人口统计学、合并症、与损伤相关的数据和术前实验室生物标志物。通过常规术前多普勒检查诊断双侧下肢 DVT。采用单因素分析和多因素 logistic 回归分析确定独立危险因素。共有 98 例患者术前发生 DVT,发生率为 6.4%。共发现 164 个血栓,涉及 6 条静脉,平均每个患者 1.7 个。具体涉及的静脉 DVT 如下:2 例股总静脉,7 例股浅静脉,2 例股深静脉,16 例腘静脉,49 例胫后静脉,88 例腓静脉。在多因素模型中,确定了 5 个与 DVT 相关的危险因素,包括年龄(每增加 10 岁)、性别、较低的 ALB 水平、较低的 LYM 计数和较高的 D-二聚体水平。糖尿病有增加 DVT 风险的趋势,但无统计学意义(p=0.063)。这些关于 DVT 的流行病学数据可能有助于向患者提供 DVT 的风险、个体化风险评估以及相应的风险分层。

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本文引用的文献

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Risk factors for symptomatic venous thromboembolism following surgery for closed ankle fractures: A case-control study.
Foot Ankle Surg. 2020 Aug;26(6):681-686. doi: 10.1016/j.fas.2019.08.006. Epub 2019 Aug 28.
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