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分析创伤性脊柱骨折合并脊髓损伤术后深静脉血栓形成的危险因素。

Analysis of Risk Factors for Postoperative Deep Vein Thrombosis in Traumatic Spinal Fracture Complicated with Spinal Cord Injury.

机构信息

The First College of Clinical Medical Science, China Three Gorges University. Department of Spinal Surgery, Yichang Central People's Hospital, Yichang, PR China.

出版信息

Clin Appl Thromb Hemost. 2024 Jan-Dec;30:10760296241271331. doi: 10.1177/10760296241271331.

Abstract

The purpose of this study is to investigate the risk factors for postoperative deep vein thrombosis (DVT) in patients with traumatic spinal fractures complicated with Spinal Cord Injury(SCI). We conducted a retrospective analysis of 110 patients with traumatic spinal fractures and SCI admitted to our hospital from March 2021 to April 2024. DVT was diagnosed using ultrasound. Patient history, general data, surgical data, laboratory tests, and thromboelastogram (TEG) results were collected. The patients were divided into a DVT group and a non-DVT group according to the results of ultrasound one week after surgery. The risk factors and diagnostic value were analyzed using binary logistic regression and receiver operating characteristic (ROC) curves in both univariate and multivariate analyses. Multivariate and ROC analysis results showed that D-dimer, lower extremity, duration of bedrest, and MA values of TEG were independent risk factors for DVT in SCI, with D-dimer having the highest diagnostic value (AUC = 0.883). The AUC values for lower extremity, duration of bedrest, and MA were 0.731, 0.750, and 0.625. In conclusion, Postoperative D-dimer > 5.065 mg/l, lower extremity < 3, duration of bedrest, and MA value of TEG are independent risk factors for postoperative DVT in SCI patients, D-dimer having the highest diagnostic value. When the above risk factors occur, clinicians need to be vigilant and take appropriate prevention and treatment measures.

摘要

本研究旨在探讨外伤性脊柱骨折合并脊髓损伤(SCI)患者术后深静脉血栓形成(DVT)的危险因素。我们对 2021 年 3 月至 2024 年 4 月我院收治的 110 例外伤性脊柱骨折合并 SCI 患者进行回顾性分析。采用超声诊断 DVT。收集患者病史、一般资料、手术资料、实验室检查和血栓弹力图(TEG)结果。根据术后一周超声结果将患者分为 DVT 组和非 DVT 组。采用单因素和多因素二分类 logistic 回归及受试者工作特征(ROC)曲线分析危险因素及诊断价值。多因素及 ROC 分析结果显示,D-二聚体、下肢、卧床时间及 TEG 的 MA 值是 SCI 患者发生 DVT 的独立危险因素,D-二聚体的诊断价值最高(AUC=0.883)。下肢、卧床时间及 MA 的 AUC 值分别为 0.731、0.750 和 0.625。结论:术后 D-二聚体>5.065mg/L、下肢<3、卧床时间及 TEG 的 MA 值是 SCI 患者术后发生 DVT 的独立危险因素,D-二聚体的诊断价值最高。当出现上述危险因素时,临床医生需要警惕并采取适当的预防和治疗措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/300c/11322941/9b826c2e3db6/10.1177_10760296241271331-fig1.jpg

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