CAJ | 학술논문

目的探讨股骨干骨折后并发下肢深静脉血栓形成(DVT)的危险因素,以制定防治策略.方法回顾性分析自2011年1月至2014年2月收治的67例股骨干骨折患者的临床资料,男45例,女22例;年龄18 ～55岁.以静脉造影阳性结果为诊断DVT的“金标准”,其中血栓组18例(26.9％),非血栓组49例(73.1％).收集患者的基本信息、骨折分型、内科合并症、血管神经损伤、D-二聚体水平、下肢深静脉超声、造影检查的结果、麻醉方法、手术方式、手术时间等.采用logistic回归分析确定股骨干骨折后并发下肢DVT的危险因素. 结果复杂骨折(OR=3.773,P=0.038)、合并血管神经损伤(OR=2.603,P=0.002)、D-二聚体水平升高(OR=1.697,P=0.002)、下肢深静脉超声阳性(OR=3.068,P＜0.001)是导致股骨干骨折后新发下肢DVT风险增高的独立危险因素. 结论骨折类型复杂和合并血管神经损伤是股骨干骨折后并发下肢DVT的主要危险因素,D-二聚体水平检测和下肢深静脉超声检查是主要筛查方法.
목적 탐토고골간골절후병발하지심정맥혈전형성(DVT)적위험인소,이제정방치책략.방법 회고성분석자2011년1월지2014년2월수치적67례고골간골절환자적림상자료,남45례,녀22례;년령18 ～55세.이정맥조영양성결과위진단DVT적“금표준”,기중혈전조18례(26.9％),비혈전조49례(73.1％).수집환자적기본신식、골절분형、내과합병증、혈관신경손상、D-이취체수평、하지심정맥초성、조영검사적결과、마취방법、수술방식、수술시간등.채용logistic회귀분석학정고골간골절후병발하지DVT적위험인소. 결과 복잡골절(OR=3.773,P=0.038)、합병혈관신경손상(OR=2.603,P=0.002)、D-이취체수평승고(OR=1.697,P=0.002)、하지심정맥초성양성(OR=3.068,P＜0.001)시도치고골간골절후신발하지DVT풍험증고적독립위험인소. 결론 골절류형복잡화합병혈관신경손상시고골간골절후병발하지DVT적주요위험인소,D-이취체수평검측화하지심정맥초성검사시주요사사방법.
Objective To analyze the risk factors of lower limb deep vein thrombosis (DVT) following femoral shaft fracture.Methods A retrospective study was conducted to analyze the 67 patients with femoral shaft fracture who had been treated at our department from January 2011 to February 2014.They were 45 men and 22 women,18 to 55 years of age.A positive result of venous contrast examination was taken as the gold standard for diagnosis of lower limb DVT.There were 18 patients in the DVT group (26.9％) and 49 in the non-DVT group (73.1％).The data were analyzed concerning general clinical information,fracture type,complications,vascular injury,D-dimer level,venous ultrasonography,venous contrast examination,anesthesia methods,operative methods,operation time and bleeding volume.The risk factors of DVT were determined using Logistic regression analysis.Results Complex fracture (OR =3.773,P =0.038),combined vascular injury (OR =2.603,P =0.002),increased D-dimer level (OR =1.697,P =0.002),and positive result of venous ultrasonography (OR =3.068,P ＜ 0.001) were identified as the independent risk factors for lower limb DVT.Conclusions The major risk factors of lower limb DVT following femoral shaft fracture are complex fracture and vascular injury.The main screening methods of lower limb DVT are D-dimer level test and venous ultrasonography.