口腔颌面外科术后经ICU过渡患者下肢深静脉血栓形成危险因素剖析.docVIP

口腔颌面外科术后经ICU过渡患者下肢深静脉血栓形成危险因素剖析 　　【摘要】 目的：探讨口腔颌面外科手术术后经ICU过渡患者出现下肢深静脉血栓的危险因素。方法：对2013年6月-2016年6月在宁夏医科大学总院口腔颌面外科接受手术，术后转入ICU治疗的102例患者进行回顾性调查，收集患者基本信息、基础疾病、各项检查指标、围手术期处置等，分析下肢深静脉血栓形成的危险因素。结果：所选患者下肢深静脉血栓的发生率为24.5%（25/102）。纳入的12个相关危险因素经单因素分析，只有7个因素：术中输血、ICU抗凝血治疗、白细胞计数、红细胞计数、血小板计数、手术时间和ICU卧床时间的P值小于0.2。将这7个因素进行多因素Logistic回归分析发现，患者白细胞计数升高及未应用抗凝血治疗是下肢深静脉血栓形成的危险因素（OR=1.179，P=0.032；OR=0.228，P=0.026）。结论：患者白细胞计数升高能够增加下肢深静脉血栓形成的风险，术后ICU抗凝血治疗能够显著降低下肢深静脉血栓形成。 　　【关键词】 ICU； 口腔颌面外科； 下肢深静脉血栓； 血栓形成 　　doi：10.14033/j.cnki.cfmr.2016.33.004 文献标识码 A 文章编号 1674-6805（2016）33-0009-03 　　【Abstract】 Objective：To investigate the risk factors of deep venous thrombosis of lower limb for postoperative patients of oral and maxillofacial surgery during ICU transition.Method：102 patients who were underwent surgery from June 2013 to June 2016 in the department of oral and maxillofacial surgery，General Hospital of Ningxia Medical University and were transfered in ICU after surgery were retrospectively investigated.Their basic information，basic diseases，check indexes and perioperative treatment were collected，the risk factors of deep venous thrombosis of lower limb were analyzed.Result：The incidence of deep venous thrombosis rate was 24.5%（25/102） in the study.12 related risk factors were involved in the single factor analysis.There were 7 factors with P value less than 0.2：the intraoperative blood transfusion，ICU anticoagulant therapy，number of white blood cells，number of red blood cells，number of platelets，operation time and lying-bed time in ICU.Multivariate Logistic regression analysis for those 7 factors showed that elevated WBC count and without the application of anticoagulant therapy were the risk factors of deep vein thrombosis（OR=1.179，P=0.032；OR=0.228，P=0.026）.Conclusion：Elevated WBC count can increase the risk of deep venous thrombosis of lower limb.The postoperative ICU anticoagulant therapy can significantly reduce the deep venous thrombosis of lower limbs. 　　【Key words】 ICU； Oral and ma