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股骨粗隆间骨折患者的深静脉血栓形成:一项回顾性研究

Deep Vein Thrombosis in Patients with Intertrochanteric Fracture: A Retrospective Study.

作者信息

Fei Chen, Wang Peng-Fei, Qu Shuang-Wei, Shang Kun, Yang Kun, Li Zhi, Zhuang Yan, Zhang Bin-Fei, Zhang Kun

机构信息

Department of Orthopedic Trauma, Honghui Hospital, Xi'an Jiaotong University College of Medicine, Beilin District, No. 555 Youyi East Road, Xi'an, 710054 Shaanxi China.

Xi'an Medical University, Beilin District, Hanguang North Road, Xi'an, Shaanxi China.

出版信息

Indian J Orthop. 2020 Jul 11;54(Suppl 1):101-108. doi: 10.1007/s43465-020-00166-8. eCollection 2020 Sep.

Abstract

BACKGROUND

This study aimed to investigate the incidences of pre- and post-operative lower extremity deep venous thrombosis (DVT) in hospitalized patients with intertrochanteric fractures and to analyze the relevant risk factors.

METHODS

A retrospective study was conducted between July 2014 and October 2016 in 218 intertrochanteric fracture patients who presented at Xi'an Honghui Hospital and underwent Doppler ultrasonography for DVT diagnosis. We divided DVT into distal, proximal, and mixed thrombosis. Patients were divided into either the thrombosis or no thrombosis group according to preoperative and postoperative ultrasonography results. All patients were evaluated for the risk factors associated with thrombosis.

RESULTS

A total of 37.61% of preoperative patients had DVT, and the postoperative incidence increased to 58.72%. The days between fracture and hospitalization and the days between fracture and surgery were independent risk factors for preoperative DVT. The days between fracture and hospitalization and d-dimer levels at postoperative 1 day were independent risk factors of postoperative DVT. In total 23.4% of the patients progressed from having no thrombosis preoperatively to having distal, proximal, or mixed DVT postoperatively (22.02%, 0.46%, and 0.92%, respectively). Distal DVT constituted 86.59% and 90.63% of all preoperative and postoperative DVTs, respectively.

CONCLUSION

Intertrochanteric fracture is a common type of hip fracture in the elderly, and the incidence of DVT after intertrochanteric fracture may be underestimated. Early intervention (early admission and early surgery) might reduce the incidence of DVT.

摘要

背景

本研究旨在调查股骨转子间骨折住院患者术前和术后下肢深静脉血栓形成(DVT)的发生率,并分析相关危险因素。

方法

对2014年7月至2016年10月在西安红会医院就诊并接受多普勒超声检查以诊断DVT的218例股骨转子间骨折患者进行回顾性研究。我们将DVT分为远端、近端和混合性血栓形成。根据术前和术后超声检查结果将患者分为血栓形成组或无血栓形成组。对所有患者进行与血栓形成相关的危险因素评估。

结果

术前共有37.61%的患者发生DVT,术后发生率升至58.72%。骨折至住院天数和骨折至手术天数是术前DVT的独立危险因素。骨折至住院天数和术后1天的D-二聚体水平是术后DVT的独立危险因素。共有23.4%的患者从术前无血栓形成进展为术后发生远端、近端或混合性DVT(分别为22.02%、0.46%和0.92%)。远端DVT分别占术前和术后所有DVT的86.59%和90.63%。

结论

股骨转子间骨折是老年人常见的髋部骨折类型,股骨转子间骨折后DVT的发生率可能被低估。早期干预(早期入院和早期手术)可能会降低DVT的发生率。

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