膝关节镜手术术后静脉血栓形成危险因素分析

Analysis of risk factors related to venous thromboembolism after knee arthroscopy

摘要:

目的??分析膝关节镜术后静脉血栓形成的危险因素。方法?回顾性分析该院2012年1月-2016年3月符合纳入和排除标准的膝关节镜术后形成静脉血栓的患者29例，以术者、手术时间为匹配条件，按照1∶2配比，选取对照病例58例，对年龄、性别、体质指数（BMI）、吸烟与否、血脂是否异常、手术类型、止血带应用时间、麻醉方式、手术时间及Caprini评分进行评估，分析膝关节手术术后静脉血栓形成的危险因素。结果?共有29名患者术后并发静脉血栓（均为肌间静脉血栓），总体静脉血栓发生率为1.17%，经过单因素分析、非条件Logistic回归分析发现：年龄的OR=1.09，95%CI（1.03，1.16）。Caprini评分的OR=2.97，95%CI（1.39，6.32）。结论?该研究表明膝关节镜手术术后静脉血栓形成发生率不高，年龄增长及Caprini评分增大是血栓形成的危险因素，鉴于静脉血栓的严重后果，应重视关节镜手术围手术期静脉血栓的预防，但预防措施要个体化，以免抗凝药物滥用。

Abstract:

Objective?To determine the risk factors related to venous thromboembolism after knee arthroscopy.?Methods?A retrospective study including patients from Feb 2012 to Mar 2016 was carried out to analyze the risk factors of venous thromboembolism after knee arthroscopy. A 1∶2 matched control group was generated according to the surgeon and the date. Preoperative and perioperative data were collected with respect to age, gender, body mass index, smoking, blood fat, surgical procedure, the time length of ligating tourniquet, anesthesia methods, surgery time and Caprini evaluation. Univariate and multivariate analyses were performed.?Results?29 cases of venous thromboembolic events (VTEs) occurred, resulting in an incidence rate of 1.17%. Factors associated with an elevated risk of postoperative VTEs included age OR=1.09, 95%CI (1.03, 1.16) and Caprini evaluation OR=2.97, 95% CI (1.39, 6.32).?Conclusions?In this study, VTEs occurred infrequently. Considering the serious result of VTEs, it is important to prevent it. Age and Caprini are associated with elevated risk of postoperative VTEs. It is essential to target those at high risk for VTEs and appropriately treat those patients.