摘要
目的探讨胫骨平台骨折患者术前下肢深静脉血栓(deep venous thrombosis,DVT)发生率并对其影响因素进行分析。方法回顾分析2012年11月至2014年6月,我院创伤骨科经治的资料完整的336例(男235例;女101例)胫骨平台骨折患者术前下肢DVT发生情况,336例患者的平均年龄(47.5±13.6)岁。分析可能影响胫骨平台骨折患者发生下肢DVT的因素包括以下五类:基本影响因素,合并基础疾病,胫骨平台骨折相关因素,凝血系列实验室指标,合并损伤。连续变量、分类变量类因素同DVT的相关性,分别采用独立样本t检验和卡方检验方式确定。独立影响因素采用多重Logistic回归对可能影响DVT形成的单一因素进一步分析,以确定影响胫骨平台骨折患者术前DVT形成的高危因素。结果 58例(17.3%)通过下肢深静脉彩超或静脉造影确诊下肢DVT形成。单因素分析结果显示:年龄、性别、受伤原因、合并多发骨折、合并骨盆髋臼脊柱骨折、Schatzker分型、D-Dimer和部分凝血活酶时间(activated partial thromboplastin time,APTT)水平几项因素,可能影响急性胫骨平台骨折患者术前下肢DVT的形成。多因素Logistic回归分析结果显示:致伤原因中高处坠落伤、高水平D-Dimer和APTT时间延长是影响其术前DVT形成的独立危险因素。结论急性胫骨平台骨折患者术前下肢DVT发生率并不低;高处坠落伤、D-D二聚体水平升高、APTT延长是其独立影响因素;临床工作中对具有高危因素的胫骨平台骨折患者应当警惕下肢DVT的发生。
Objective To explore the incidence of lower limb deep venous thrombosis（ DVT） before the surgery in the patients with tibial plateau fractures and to analyze the risk factors. Methods From November 2012 to June 2014, 336 patients with complete data were adopted, including 235 males and 101 females. Their mean age was（ 47.5±13.6） years old. The collected indexes could be divided into 5 categories, including general factors, basic medical diseases, indexes related to tibial plateau fractures, hematological examination and associated injuries. The association between the indexes and DVT was ascertained by independent-sample T-test for continuous variables and chi-square test for categorical variables. Multiple logistic regression was used to further analyze the independent factors for DVT, so as to identify the high risk factors for lower limb DVT before the surgery in the patients with tibial plateau fractures. Results Lower limb DVT was confirmed in 58 of the 336 patients（ 17.3%） by color Doppler ultrasound（ CDUS） or venography. The univariate analysis of potential factors for DVT showed significant associations between lower limb DVT and age, gender, cause of injuries, multiple fractures, pelvis-acetabular and spine fractures, Schatzker classification and levels of D-Dimer and activated partial thromboplastin time（ APTT）. Furthermore, multiple logistic regression analysis showed that cause of injuries（ high falling injuries） and levels of APTT and D-Dimer were independent predictors of DVT. Conclusions It is demonstrated that the patients with acute tibial plateau fractures have a high risk of lower limb DVT before the surgery. Furthermore, the independent predictors of DVT are cause of injuries（ high falling injuries） and levels of APTT and D-Dimer. Clinically, great attention should be paid to the patients with acute tibial plateau fractures in case of lower limb DVT.
出处
《中国骨与关节杂志》
CAS
2015年第2期86-90,共5页
Chinese Journal of Bone and Joint
关键词
静脉血栓形成
胫骨骨折
危险因素
胫骨
骨折
Venous thrombosis
Tibial fractures
Risk factors
Tibia
Fractures
bone
作者简介
通信作者：王满宜，Email：jstwang@sina．cn
