目的 回顾分析创伤性截瘫患者康复早期下肢深静脉血栓(DVT)形成特点及其影响因素。方法 以2014年6月至2017年6月本院连续收治的脊髓损伤患者为对象,选取其中创伤性截瘫康复早期患者进行回顾,收集临床信息、下肢静脉彩超、实验室检查等资料,统计分析DVT形成特点及其影响因素。结果 共纳入创伤性截瘫康复早期患者269例,有下肢DVT形成62例(23.0%),其中50例发生于下肢远端(80.6%),28例为双下肢同时发生(45.2%)。<14岁患者未见下肢DVT形成(31例)。多元Logistic回归分析显示,D-dimer升高(OR=1.348, 95%CI 1.193~1.525)、高龄(OR=3.450, 95%CI 1.372~8.674)、男性(OR=2.872, 95%CI 1.095~7.533)和患有糖尿病(OR=5.319, 95% CI 1.094~25.872)是该人群下肢DVT形成的独立影响因素。结论 创伤性截瘫患者在康复早期下肢DVT形成的发生率较高,主要发生在下肢远端,两侧同时发生多见。儿童患者下肢DVT发生率低。D-dimer升高、高龄、男性和患有糖尿病是该人群下肢DVT形成的独立影响因素。
Objective To retrospectively analyze the features and related factors of deep venous thrombosis (DVT) in patients with traumatic paraplegia during early rehabilitation.Methods Inpatients of our hospital from June, 2014 to June, 2017 were included and patients with traumatic paraplegia during early rehabilitation were analyzed. The clinical information, lower limbs deep vein ultrasonic testing and laboratory examination were collected to analyze features and related factors of DVT.Results A total of 269 patients with traumatic paraplegia during early rehabilitation were analyzed and 62 patients had DVT in lower limbs (23.0%), in which 50 patients had an isolated distal DVT and 28 cases occurred in bilateral lower limbs (45.2%). No patients younger than 14 had DVT in lower limbs (n=31). Logistic regression analysis showed that increased D-dimer (OR=1.348, 95% CI 1.193~1.525), advanced age (OR=3.450, 95% CI 1.372~8.674), male (OR=2.872, 95% CI 1.095~7.533) and diabetes (OR=5.319, 95% CI 1.094~25.872) were independent related factors for DVT.Conclusion The incidence of DVT in lower limbs of traumatic paraplegia patients during early rehabilitation is high. DVT develops mainly distally to the popliteal vein and bilaterally of lower limbs. Prepubertal children have a low incidence of DVT. Increased D-dimer, advanced age, male and diabetes are independent related factors for DVT.
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