解放军医学杂志2025，Vol.50Issue(9)：1117-1121,5.DOI:10.11855/j.issn.0577-7402.1125.2025.0423
腰椎退行性疾病术后下肢深静脉血栓形成特点及危险因素分析
Characteristics and risk factors of postoperative lower extremity deep vein thrombosis in patients with lumbar degenerative diseases
摘要
Abstract
Objective To analyze the characteristics and risk factors associated with postoperative deep vein thrombosis(DVT)of the lower extremities in patients undergoing surgery for lumbar degenerative diseases.Methods A retrospective analysis was conducted on clinical data from 298 patients who were hospitalized for lumbar degenerative diseases and underwent lumbar spine surgery treatment in the First Affiliated Hospital of Nanchang University from October 1,2022 to April 15,2023.Patients were divided into DVT group(n=71)and non-DVT group(n=227)according to whether DVT of the lower limbs occurred within 1 week postoperatively.The incidence and distribution characteristics of postoperative DVT were analyzed.Univariate and binary logistic regression analyses were performed to identify risk factors for DVT,and receiver operating characteristic(ROC)curves were used to determine cut-off values for relevant risk factors.Results A total of 298 patients were included,among whom 159 were males(53.4%)and 139 were females(46.6%),with an average age of(64.5±9.8)years.DVT occurred in 71 patients,and the incidence of lower extremity DVT was 23.8%.In the DVT group,there were 49 cases(69.0%)of intermuscular vein thrombosis,and 22 cases of other types of thrombosis(7 cases of peroneal vein thrombosis,4 cases of posterior tibial vein thrombosis,3 cases of common femoral vein thrombosis,1 case of anterior tibial vein thrombosis,and 7 cases of multiple thrombosis);58 cases(81.7%)had DVT in one lower extremity,and 13 cases(18.3%)had DVT in both lower extremities.Univariate analysis results showed that age,body mass index(BMI),length of hospital stay,history of hypertension,operative time,and intraoperative blood loss were associated with the occurrence of lower extremity DVT after surgery for lumbar degenerative diseases(P<0.05).Binary logistic regression analysis results indicated that older age(OR=1.079,P<0.01),higher BMI(OR=1.130,P=0.01),history of hypertension(OR=2.992,P<0.01),and larger intraoperative blood loss(OR=1.002,P=0.03)were independent risk factors for the occurrence of lower extremity DVT.ROC curve analysis demonstrated that patients with age>58.5 years,BMI>24.01 kg/m2,history of hypertension,and intraoperative blood loss>550 ml had a significantly increased risk of postoperative lower limb DVT.Conclusions The incidence of lower extremity DVT after surgery for lumbar degenerative disease is high,and intermuscular venous thrombosis is more common.Older age,higher BMI,history of hypertension,and larger intraoperative blood loss are independent risk factors for the occurrence of lower extremity DVT after surgery.关键词
腰椎退行性疾病/下肢深静脉血栓/危险因素/术后并发症Key words
lumbar degenerative diseases/lower extremity deep vein thrombosis/risk factors/postoperative complications分类
医药卫生引用本文复制引用
孙伯林,熊绪,钟彦鑫,刘宇,杜浏学,陶腾辉,黄山虎,刘志礼,刘家明..腰椎退行性疾病术后下肢深静脉血栓形成特点及危险因素分析[J].解放军医学杂志,2025,50(9):1117-1121,5.基金项目
This work was supported by the Science and Technology Project of Jiangxi Provincial Health Commission(202410014),and the Key Research and Development Program of Jiangxi Province(20223BBG71S02) 江西省卫健委科技计划项目(202410014) （202410014）
江西省重点研发计划项目(20223BBG71S02) （20223BBG71S02）
