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单髁置换术后下肢深静脉血栓形成的危险因素分析
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Abstract:
目的：探究单髁膝关节置换(UKA)术后发生下肢深静脉血栓(DVT)的危险因素。方法：回顾性分析2023年1月至2024年5月于我院接受UKA治疗的患者围术期临床资料，通过单因素分析筛选潜在危险因素，将有显著差异的指标纳入多因素Logistic回归进行统计分析，确定UKA术后DVT的独立危险因素，所有统计以P < 0.05认为有统计学意义。结果：本研究共纳入174名患者，其中DVT组32名患者，非DVT组142名患者。单因素分析显示，两组患者在年龄、手术时间、失血量、止血带时间、术后第一天D-二聚体、合并高血压、麻醉方式、下肢X线评分这8个指标上存在显著差异(P均 < 0.05)。多因素Logistic回归进一步确定年龄、止血带时间、术后第一天D-二聚体、下肢X线评分(4级)是UKA术后DVT发生的独立危险因素(P均 < 0.05)。结论：UKA术后DVT与多种因素有关，临床医师要尽早识别UKA术后发生DVT的危险因素并尽早采取预防性措施，降低围术期不良事件的发生率。
Objective: This study aims to explore the risk factors for DVT after UKA. Method: This was a retrospective study that included patients who underwent UKA at our hospital from January 2023 to May 2024. Data collection included patients’ demographic characteristics, perioperative examinations, imaging data, operative time, tourniquet time, blood loss, and vascular ultrasound findings. Univariate analysis was initially conducted to identify potential risk factors based on differences between groups. Significant differences were included in multivariate Logistic regression analysis to determine the independent risk factors for DVT after UKA. A P-value < 0.05 was considered statistically significant. Results: A total of 174 patients were included in this study, with 32 in the DVT group and 142 in the non-DVT group. Univariate analysis showed significant differences between the two groups in eight factors: age, operative time, blood loss, tourniquet time, postoperative day 1 D-dimer levels, hypertension, anesthesia type, and X-ray grading (P < 0.05). Multivariate Logistic regression further identified age (P = 0.011, OR = 1.127), tourniquet time (P = 0.047, OR = 1.060), postoperative day 1 D-dimer levels (P < 0.001, OR = 1.971), and lower limb X-ray grading (Grade 4) (P = 0.018, OR = 4.527) as independent risk factors for DVT after UKA. Conclusion: The results of this study indicated that age, tourniquet time, postoperative day 1 D-dimer levels, and lower limb X-ray grading (Grade 4) are independent risk factors for DVT after UKA. Surgeons should identify these risk factors in advance and take preventive measures early to reduce the incidence of perioperative adverse events, accelerate patient recovery, and improve patient outcomes.
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