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急性出血性脑卒中患者下肢深静脉血栓形成的现状及影响因素分析

Analysis of the current status and influencing factors of LEDVT in patients with acute hemorrhagic stroke.

作者信息

Chen Xuemei, Sui Zhao, Ting Jing, Qi Minjin, Yin Yijing, He Furong

机构信息

Department of Neurosurgery, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China.

出版信息

Medicine (Baltimore). 2025 Mar 21;104(12):e41759. doi: 10.1097/MD.0000000000041759.

Abstract

Lower extremity deep venous thrombosis (LEDVT) is a common complication in patients with acute hemorrhagic stroke, leading to increased risk of pulmonary embolism, disability, and mortality. Despite its importance, LEDVT often goes undetected in clinical practice, and early preventive strategies remain insufficient. This study aimed to explore the incidence of LEDVT in acute hemorrhagic stroke patients, identify key risk factors, and discuss potential preventive measures to reduce its occurrence and improve patient outcomes. A retrospective analysis was conducted on 431 acute hemorrhagic stroke patients admitted to The First Affiliated Hospital of Chengdu Medical College between January 2022 and December 2023. Relevant clinical data, including patient demographics, comorbidities, NIHSS score, and treatment history, were collected. LEDVT was diagnosed using standardized ultrasound criteria. Statistical analyses, including univariate and multivariate logistic regression, were performed using SPSS 17.0 to identify independent risk factors associated with LEDVT. The incidence of LEDVT among the 431 acute hemorrhagic stroke patients was 12.1%, with 52 cases identified. Significant risk factors for LEDVT included advanced age, diabetes, infection, prolonged bed rest, high-dose diuretic use, NIHSS score ≥16, and hyperlipidemia (P < .05). Gender, smoking history, and alcohol consumption were not found to be statistically significant. Multivariate logistic regression revealed that advanced age, diabetes, infection, prolonged bed rest, high-dose diuretic use, NIHSS score ≥16, and hyperlipidemia were independent risk factors for LEDVT. LEDVT in acute hemorrhagic stroke patients is influenced by multiple factors, including comorbidities, severity of neurological impairment, and treatment regimens. Dehydration therapy used for managing brain edema and intracranial pressure was also found to be an independent risk factor. Given the significant impact of LEDVT on patient prognosis, early identification of at-risk patients and the implementation of proactive preventive measures-such as pharmacological treatments and physical interventions-are critical in reducing the occurrence of LEDVT, alleviating patient suffering, and improving long-term outcomes. Future studies should focus on refining preventive strategies and exploring more individualized interventions to further reduce the incidence of LEDVT in these patients.

摘要

下肢深静脉血栓形成(LEDVT)是急性出血性中风患者的常见并发症,会导致肺栓塞、残疾和死亡风险增加。尽管其很重要,但LEDVT在临床实践中常未被发现,且早期预防策略仍不足。本研究旨在探讨急性出血性中风患者中LEDVT的发生率,确定关键危险因素,并讨论潜在的预防措施以减少其发生并改善患者预后。对2022年1月至2023年12月期间成都医学院第一附属医院收治的431例急性出血性中风患者进行了回顾性分析。收集了相关临床数据,包括患者人口统计学资料、合并症、美国国立卫生研究院卒中量表(NIHSS)评分和治疗史。使用标准化超声标准诊断LEDVT。使用SPSS 17.0进行统计分析,包括单因素和多因素逻辑回归,以确定与LEDVT相关的独立危险因素。431例急性出血性中风患者中LEDVT的发生率为12.1%,共确诊52例。LEDVT的显著危险因素包括高龄、糖尿病、感染、长期卧床休息、大剂量使用利尿剂、NIHSS评分≥16以及高脂血症(P < .05)。未发现性别、吸烟史和饮酒在统计学上有显著意义。多因素逻辑回归显示,高龄、糖尿病、感染、长期卧床休息、大剂量使用利尿剂、NIHSS评分≥16以及高脂血症是LEDVT的独立危险因素。急性出血性中风患者的LEDVT受多种因素影响,包括合并症、神经功能缺损严重程度和治疗方案。用于治疗脑水肿和颅内压的脱水疗法也被发现是一个独立危险因素。鉴于LEDVT对患者预后有重大影响,早期识别高危患者并实施积极的预防措施,如药物治疗和物理干预,对于减少LEDVT的发生、减轻患者痛苦和改善长期预后至关重要。未来的研究应专注于完善预防策略并探索更个体化的干预措施,以进一步降低这些患者中LEDVT的发生率。

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Anatomical distribution of lower-extremity deep venous thrombosis in patients with acute stroke.下肢深静脉血栓形成在急性脑卒中患者中的解剖分布。
J Stroke Cerebrovasc Dis. 2020 Jul;29(7):104866. doi: 10.1016/j.jstrokecerebrovasdis.2020.104866. Epub 2020 May 11.

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