老年髋部骨折术前深静脉血栓发生率及危险因素分析
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Pre-operative incidence of deep venous thrombosis and its risk factors in the elderly with hip fracture
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    摘要:

    目的 研究老年髋部骨折术前深静脉血栓(DVT)的发生率及其危险因素,从而促进DVT的预防。方法 回顾性分析解放军总医院2008年3月至2012年10月收治的老年髋部骨折患者386例,根据术前双下肢静脉彩超结果分为DVT组和非DVT组,分析糖尿病、肿瘤、心血管病、呼吸疾病、肝病、肾病、风湿病及痴呆等危险因素。结果 术前34例(8.8%)确诊为DVT,其中股静脉2例(5.88%),腘静脉4例(11.76%),胫后静脉1例(2.94%),单侧小腿肌间静脉20例(58.82%),双侧小腿肌间静脉5例(14.71%),腓静脉2例(5.88%)。术前因肺动脉栓塞死亡3例。BMI≥30.0 kg/m2、风湿病史、合并≥3种内科疾病为术前DVT发生的独立危险因素(P<0.05)。结论 老年髋部骨折术前DVT发生率高,BMI≥30.0 kg/m2、风湿病史及合并≥3种内科疾病的患者入院后应评估血栓风险,积极预防,以减少DVT的发生。

    Abstract:

    Objective To investigate the pre-operative incidence of deep venous thrombosis(DVT) and its risk factors in the senile patients with hip fracture. Methods Clinical data of 386 consecutive senile patients suffering from hip fracture admitted in our hospital from March 2008 to November 2012 were collected in this study, and retrospectively analyzed. The patients were divided into DVT group and non-DVT group according to the results of lower extremity venous ultrasonography before operation. Risk factors, such as diabetes, cancer, cardiovascular disease, respiratory disease, liver disease, kidney disease, rheumatism and dementia were analyzed and compared between the 2 groups. Results There were 34 patients(8.8%) diagnosed as being accompanied with DVT before operation, including 20 of unilateral calf vein embolism(58.82%), 5 of bilateral calf vein embolism (14.71%), 4 of popliteal vein embolism(11.76%), 2 of femoral vein embolism(5.88%), 2 of peroneal vein embolism(5.88%) and 1 of posterior tibial vein embolism(2.94%). Three patients died of pulmonary embolism before operation. BMI ≥30.0kg/m2, history of rheumatism, and ≥3 comorbidities were independent risk factors of pre-operative incidence of DVT in the elderly with hip fracture(P<0.05). Conclusion Pre-operative incidence of DVT is rather high in the senile patients with hip fracture. For those with BMI ≥30.0kg/m2, history of rheumatism, and ≥3 comorbidities, clinicians should assess the risk of embolism, and take preventive measures prevent actively to reduce the incidence of DVT.

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谭 晶,张 静,孟钰童,张里程,唐佩福*.老年髋部骨折术前深静脉血栓发生率及危险因素分析[J].中华老年多器官疾病杂志,2016,15(05):373~376

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  • 收稿日期:2015-12-04
  • 最后修改日期:2016-03-31
  • 录用日期:2016-03-31
  • 在线发布日期: 2016-05-27
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