Department of Ultrasound Medicine, 592469Baoding No.1 Central Hospital, Baoding, P.R. China.
Department of Orthopaedic Surgery, 592469Baoding No.1 Central Hospital, Baoding, P.R. China.
Clin Appl Thromb Hemost. 2023 Jan-Dec;29:10760296231153123. doi: 10.1177/10760296231153123.
To investigate the dynamic changes and relevant factors of deep vein thrombosis (DVT) in patients with thoracolumbar fractures caused by high-energy injuries.
From January 2016 to June 2021, a total of 655 patients with thoracolumbar fractures who underwent surgical treatment in our hospital were retrospectively analyzed. The patients were examined by preoperative and postoperative ultrasonography, and divided into thrombus growth group, thrombus invariant group, and thrombus regression group according to the preoperative and postoperative ultrasonographic results. Medical record data, including demographic data, surgical data, and laboratory results, were collected and the differences in various factors among the groups were compared.
DVT was found in 99 patients (15.1%, 99/655) before surgery, including 79 cases of distal thrombus, 7 cases of proximal thrombus, and 13 cases of mixed thrombus. The incidence of postoperative DVT increased to 20.6% (134/655), including 96 cases of distal thrombus, 15 cases of proximal thrombus, and 23 cases of mixed thrombus. Among them, 39.7% had thrombus growth, 49.3% had thrombus basically unchanged and 11.0% had thrombolysis. There were significant differences in age, lower extremity muscle strength, time from trauma to surgery, operation time, blood loss, blood transfusion, and post 3-D-dimer among the three groups.
In patients with thoracolumbar fractures caused by high-energy injuries, the majority of patients with DVT do not change or grow after surgery, and only a few of them have thrombolysis. Younger age, lower extremity motor, and fewer blood transfusion contribute to thrombolysis. Delayed surgical intervention, longer operation time, and higher blood loss can lead to thrombosis growth. Post 3-D-dimer is closely related to the dynamic changes of thrombus.
探讨高能损伤致胸腰椎骨折患者深静脉血栓（DVT）的动态变化及相关因素。
回顾性分析 2016 年 1 月至 2021 年 6 月我院收治的 655 例手术治疗的胸腰椎骨折患者，术前及术后均行超声检查，根据术前及术后超声结果将患者分为血栓增长组、血栓不变组和血栓消退组。收集患者的病历资料，包括人口统计学资料、手术资料和实验室结果，并比较各组间各因素的差异。
术前发现 DVT99 例（15.1%，99/655），其中远端血栓 79 例，近端血栓 7 例，混合血栓 13 例；术后 DVT 发生率上升至 20.6%（134/655），其中远端血栓 96 例，近端血栓 15 例，混合血栓 23 例；其中血栓增长 39.7%，血栓基本不变 49.3%，溶栓 11.0%。三组间年龄、下肢肌力、受伤至手术时间、手术时间、出血量、输血、术后 3-D-二聚体比较，差异有统计学意义。
高能损伤致胸腰椎骨折患者术后 DVT 大部分无变化或增长，仅有少数溶栓；年龄小、下肢运动、输血少有助于溶栓；手术时间延迟、手术时间长、出血量多可导致血栓增长；术后 3-D-二聚体与血栓的动态变化密切相关。
