Zheng Xuan, Lu Xiaoli, Chen Yingbin, Wang Jundong, Qiao Jingjing
Acta Orthop Belg. 2024 Dec;90(4):665-671. doi: 10.52628/90.4.12834.
Deep venous thrombosis (DVT) has insidious clinical symptoms, and only a few patients suffer from lower limb swelling, tenderness and dorsal flexion pain. We aimed to explore the ultrasonographic features and risk factors of postoperative lower limb DVT in patients with lower limb fractures. Ninety patients with lower limb fractures admitted from January 1st, 2021 to June 30th, 2023 were selected. Color Doppler ultrasonography was performed one month after operation, and the ultrasonographic features were recorded. DVT was diagnosed according to the results of venography, based on which the patients were divided into a DVT group and a non-DVT group. Their basic and treatment-related data were compared. The risk factors for postoperative DVT were screened by multivariate logistic regression analysis. A total of 63 cases were diagnosed with DVT by venography, with a detection rate of 70.00%. A total of 69 cases were diagnosed with DVT by ultrasonography, with a detection rate of 76.67% (P>0.05). The concurrent internal medicine diseases, associated injuries, no preventive measures for thrombosis, operation time ≥2 h, no active or passive exercise after operation, pelvic and proximal femoral fractures, knee fractures and tibiofibular fractures were risk factors for postoperative DVT in patients with lower limb fractures (P<0.05). Ultrasonography is effective for diagnosing postoperative lower limb DVT in patients with lower limb fractures. Related preventive measures should be taken promptly to control the risk factors.
深静脉血栓形成(DVT)临床症状隐匿,仅有少数患者出现下肢肿胀、压痛及背屈痛。我们旨在探讨下肢骨折患者术后下肢DVT的超声特征及危险因素。选取2021年1月1日至2023年6月30日收治的90例下肢骨折患者。术后1个月行彩色多普勒超声检查,记录超声特征。根据静脉造影结果诊断DVT,并据此将患者分为DVT组和非DVT组。比较两组患者的基本资料及治疗相关资料。采用多因素logistic回归分析筛选术后DVT的危险因素。静脉造影共诊断出63例DVT,检出率为70.00%。超声检查共诊断出69例DVT,检出率为76.67%(P>0.05)。合并内科疾病、合并损伤、未采取血栓预防措施、手术时间≥2 h、术后未进行主动或被动运动、骨盆及股骨近端骨折、膝关节骨折和胫腓骨骨折是下肢骨折患者术后DVT的危险因素(P<0.05)。超声检查对诊断下肢骨折患者术后下肢DVT有效。应及时采取相关预防措施以控制危险因素。