【摘要】 [目的]初步探讨老年髋部骨折患者术前发生下肢深静脉血栓(DVT)的概率及其患病的相关危险因素。[方法]回顾性分析2016年7月~2016年12月收入我院的老年髋部骨折患者323例,按其是否发生下肢DVT分为DVT组和无DVT组。分别收集患者的性别、年龄、受伤至接受检查的时间、骨折类型、体重指数(BMI)、高血压、糖尿病、冠心病、肺部疾病、脑血管病、肿瘤、老年痴呆、肝肾疾病、周围血管疾病以及高脂血症等一般临床资料,所有入组患者均采用Charlson合并症指数(CCI)评分评估患者的内科基础状况。[结果]本研究中老年髋部骨折术前发生DVT的概率为10.84%。经单因素对比分析显示DVT组患者受伤至接受检查的时间和CCI评分明显高于无DVT组,并且具有更高的糖尿病、肺部疾病、脑血管病、肝肾疾病、周围血管疾病及高脂血症患病率(P<0.05)。进一步对差异显著的因素进行多因素Logistic回归分析显示受伤至接受检查的时间、脑血管病、周围血管病、高脂血症以及CCI是发生DVT的危险因素(P<0.05)。[结论]老年髋部骨折患者在术前具有较高的下肢DVT发生率,因此在术前均需对下肢DVT进行筛查;并且对术前等待时间较长、合并脑血管病、周围血管疾病、高脂血症及CCI较高的患者应特别警惕下肢DVT的发生。更多还原

【Abstract】 [Objective] To explore the preoperative prevalence and risk factors of deep vein thrombosis in elderly patients with osteoporotic hip fractures. [Methods] Between July 2016 and December 2016, 323 patients with hip fractures were retrospectively analyzed. The patients were divided into two groups according to whether or not lower extremity deep vein thrombosis(DVT) occurred before surgical treatment. Clinical information regarding to age, gender, elapsed time from injury to ultrasound examination, fracture type, body mass index(BMI), hypertension, diabetes, coronary heart disease, pulmonary diseases, cerebrovascular disease, tumor, senile dementia, hepatorenal disease, peripheral vascular disease and hyperlipidemia were surveyed. In addition, Charlson comorbidity index(CCI) was used to evaluate the patients medical condition. [Results] The overall prevalence of preoperative DVT was 10.84%. Compared the DVT patients with the non DVT patients, there were statistically significant differences in elapsed time from injury to ultrasound examination, CCI score, diabetes, pulmonary diseases, cerebrovascular disease, peripheral vascular disease and hyperlipidemia(P<0.05). Furthermore, multiple logistic regression demonstrated that elapsed time from injury to ultrasound examination, CCI score, cerebrovascular disease, peripheral vascular disease and hyperlipidemia were independent risk factors for preoperative DVT. [Conclusions] Our findings showed that elderly patients with hip fractures had a high prevalence of preoperative DVT, therefore the screening for preoperative DVT was necessary, especially for patients with longer time from injury to ultrasound examination, higher CCI score, cerebrovascular disease, peripheral vascular disease and hyperlipidemia.更多还原