国际麻醉学与复苏杂志   2019, Issue (11): 0-0
    
颅脑外伤术后下肢深静脉血栓影响因素分析
菅敏钰, 俞美荣, 刘海洋, 梁发, 韩如泉1()
1.北京天坛医院麻醉科
Analysis influencing factors on deep vein thrombosis formation on patients with traumatic brian injury
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摘要:

目的 探讨颅脑外伤手术患者术后发生下肢深静脉血栓的影响因素。 方法 回顾性分析289例颅脑外伤手术患者的临床资料,其中术后下肢深静脉血栓组47例,无深静脉血栓组242例。采用多因素 Logistic 回归分析检验颅脑外伤手术患者术后发生深静脉血栓的影响因素。 结果 多因素Logistic回归分析发现术前格拉斯哥昏迷评分(Glasgow Coma Scale, GCS)<10分[(P=0.004,比值比(odds ratio, OR)=1.359,95%CI 1.101~1.677]、凝血酶原时间<12.0 s(P=0.029,OR=1.945,95%CI 1.216~2.341)、蛛网膜下腔出血(P=0.013,OR=2.030,95%CI 1.502~2.781)和手术时间>3.1 h(P=0.040,OR=3.171,95%CI 2.031~3.922)是影响颅脑外伤患者下肢深静脉血栓形成的影响因素。 结论 对于术前GCS评分较低、凝血酶原时间缩短、合并蛛网膜下腔出血及手术时间长的颅脑外伤患者,应警惕术后下肢深静脉血栓的发生。

关键词: 颅脑外伤; 深静脉血栓; 影响因素
Abstract:

Objective We discussed the influencing factors on deep vein thrombosis formation on patients with traumatic brain injury. Methods A retrospective study was conducted among 289 traumatic brain injury patients who underwent craniotomy procedures at Beijing Tiantan Hospital, Capital Medical University from January 2016 to December 2018. Among them, 47 patients suffered deep vein thrombosis after surgery. We analyzed the influencing factors on deep vein thrombosis formation using multi-factor Logistic analysis. Results Multivariate logistic regression analysis revealed that preoperative Glasgow Coma Scale (GCS)<10 [P=0.004, odds ratio (OR)=1.359, 95% confidence interval (CI) 1.101-1.677], prothrombin time<12.0 s (P=0.029, OR=1.945, 95%CI 1.216-2.341), subarachnoid hemorrhage(P=0.013, OR=2.030, 95%CI 1.502-2.781) and operative time>3.1 h (P=0.040, OR=3.171, 95%CI 2.031-3.922) are factors that may influence deep veins thrombosis in traumatic brain injury patients. Conclusions For traumatic brain injury patients who have lower GCS, shorter prothrombin time, subarachnoid hemorrhage and prolonged surgery duration, clinicians should pay attention to the incidence of deep vein thrombosis.

Key words: Traumatic brain injury; Deep vein thrombosis; Influencing factors