Department of Medical Ultrasonics, 592469Baoding No.1 Central Hospital, Baoding, PR China.
Department of Orthopaedic Surgery, Baoding No.1 Central Hospital, Baoding, PR China.
Clin Appl Thromb Hemost. 2022 Jan-Dec;28:10760296221108969. doi: 10.1177/10760296221108969.
The purpose of this study was to investigate the prevalence of deep vein thrombosis (DVT) and to clarify the risk factors of DVT in patients with acute spinal cord injury (SCI) complicated with cervical fractures at admission. From January 2018 to December 2021, a total of 175 patients with acute SCI complicated with cervical fractures in our hospital were retrospectively analyzed. Duplex ultrasound was used to diagnose the DVT. All patients' medical record data, including demographic variables, medical history, and laboratory results, were collected. The patients were divided into DVT group and non-DVT group according to ultrasound results. The prevalence of DVT was determined and risk factors of DVT were identified. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic value of different factors. The prevalence of DVT at admission was 21.71%(38/175), including one (2.63%) with central DVT, thirty-two (84.21%) with peripheral DVT and five (13.16%) with mixed DVT. The multivariate analysis revealed that decreased lower extremity muscle strength, time from injury to admission, and D-dimer were risk factors for DVT at admission. The diagnostic value of D-dimer was the highest among these risk factors. In conclusion, in patients with acute SCI complicated with cervical fractures, the risk of DVT at admission is very high. Decreased lower extremity muscle strength, time from injury to admission, and D-dimer are risk factors for DVT. Moreover, D-dimer has the highest diagnostic value among these risk factors.
本研究旨在调查急性脊髓损伤（SCI）合并颈椎骨折患者入院时深静脉血栓形成（DVT）的发生率，并阐明其 DVT 的危险因素。回顾性分析 2018 年 1 月至 2021 年 12 月我院收治的 175 例急性 SCI 合并颈椎骨折患者。采用双功超声诊断 DVT。收集所有患者的病历资料，包括人口统计学变量、既往病史和实验室结果。根据超声结果将患者分为 DVT 组和非 DVT 组。确定 DVT 的发生率，并确定 DVT 的危险因素。采用受试者工作特征（ROC）曲线分析评估不同因素的诊断价值。入院时 DVT 的发生率为 21.71%（38/175），其中中央型 DVT1 例（2.63%），周围型 32 例（84.21%），混合型 5 例（13.16%）。多因素分析显示，下肢肌肉力量下降、受伤至入院时间和 D-二聚体是入院时 DVT 的危险因素。这些危险因素中，D-二聚体的诊断价值最高。综上所述，急性 SCI 合并颈椎骨折患者入院时 DVT 的风险很高。下肢肌肉力量下降、受伤至入院时间和 D-二聚体是 DVT 的危险因素。此外，D-二聚体在这些危险因素中具有最高的诊断价值。
