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腰椎内固定术后深静脉血栓形成的相关影响因素分析及治疗策略

Analysis of Related Influencing Factors of Deep Vein Thrombosis after Lumbar Internal Fixation and Treatment Strategy.

作者信息

Zhang Sixiao, Shen Guangjie, Luo Mingxing, Zhong Xiqiang

机构信息

Department of Orthopedics, Ningbo Hangzhou Bay Hospital, Ningbo, Zhejiang 315336, China.

Department of Spinal Surgery, The Third Affiliated Hospital of Wenzhou Medical University, Ruian, Zhejiang 325000, China.

出版信息

Evid Based Complement Alternat Med. 2021 Oct 19;2021:9693012. doi: 10.1155/2021/9693012. eCollection 2021.

Abstract

Lumbar internal fixation is a traditional surgical method for the treatment of degenerative diseases of the lumbar spine. However, due to its large surgical trauma, it easily causes complications such as deep venous thrombosis (DVT) after the operation. DVT refers to the abnormal coagulation of blood in deep veins, blocking the lumen, causing venous blood return disorder, causing venous blood return disorder to cause swelling and pain, which affects the recovery of the patient's lumbar spine function. In severe cases, even complicated pulmonary embolism endangers the life and health of the patient. Therefore, it is extremely important to explore the related influencing factors and effective treatment of DVT. The purpose of this study was to investigate the influencing factors and effective treatment of DVT after lumbar internal fixation. Univariate analysis and multivariate a logistic regression model were used to analyze the related factors affecting DVT after lumbar internal fixation. Conventional treatments such as anticoagulation, promotion of venous blood return, and improvement of limb circulation were given to patients with DVT, and functional exercise was guided to compare the hypercoagulability and hyperviscosity of blood in patients with DVT before and after treatment. The results showed that the incidence of DVT after lumbar internal fixation was related to age, BMI, and bed time. Getting out of bed for functional exercise in time after surgery can effectively prevent the formation of DVT. Preoperative grading examination, intraoperative intervention, postoperative physical exercise, and other preventive guidance can be carried out according to different individuals during the perioperative period to prevent the formation of postoperative DVT.

摘要

腰椎内固定术是治疗腰椎退行性疾病的传统手术方法。然而,由于其手术创伤大,术后易引发深静脉血栓形成(DVT)等并发症。DVT是指深静脉内血液异常凝结,阻塞管腔,导致静脉血液回流障碍,引起肿胀和疼痛,影响患者腰椎功能恢复。严重时,甚至并发肺栓塞,危及患者生命健康。因此,探讨DVT的相关影响因素及有效治疗方法极为重要。本研究旨在探讨腰椎内固定术后DVT的影响因素及有效治疗方法。采用单因素分析和多因素logistic回归模型分析腰椎内固定术后影响DVT的相关因素。对DVT患者给予抗凝、促进静脉血液回流、改善肢体循环等常规治疗,并指导功能锻炼,比较DVT患者治疗前后血液的高凝性和高黏滞性。结果显示,腰椎内固定术后DVT的发生率与年龄、体重指数及卧床时间有关。术后及时下床进行功能锻炼可有效预防DVT的形成。围手术期可根据不同个体进行术前分级检查、术中干预、术后体育锻炼等预防指导,以防止术后DVT的形成。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7c3/8548089/05625e79bf21/ECAM2021-9693012.001.jpg

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