Objectives: To analyze the risk factors for postoperative deep vein thrombosis (DVT) in neurosurgical patients to provide the basis for the prevention of postoperative DVT.
Methods: A total of 141 patients underwent neurosurgery were enrolled. Thrombelastography (TEG) test was performed before and at the end of surgery. According to whether there was DVT formation after operation, the patients were divided into a thrombosis group and a non-thrombosis group. T-test and rank sum test were used to compare the general clinical characteristics of the 2 groups, such as age, gender, intraoperative blood loss, D-dimer, intraoperative crystal input, colloid input, blood product transfusion, operation duration, length of postoperative hospitalization. The application of chi-square test and rank-sum test were used to compared TEG main test indicators such as R and K values between the 2 groups. Logistic regression was used to analyze the possible risk factors for postoperative DVT in neurosurgical patients.
Results: There were significant differences in postoperative TEG index R, clotting factor function, intraoperative blood loss, hypertension or not, length of postoperative hospital stay, and postoperative absolute bed time (all P<0.05). Logistic regression analysis showed hypercoagulability, more intraoperative blood loss and longer postoperative absolute bed time were risk factors for DVT formation after craniotomy.
Conclusions: Hypercoagulability in postoperative TEG test of patients is an important risk factor for the formation of postoperative DVT after neurosurgery, which can predict the occurrence of postoperative DVT to some extent.
目的: 分析开颅手术患者术后深静脉血栓(deep venous thrombosis,DVT)形成的危险因素,为预防术后DVT提供依据。方法: 收集141例开颅手术患者的人口学和临床资料,并在患者术前和手术结束时分别做一次血栓弹力图(thrombelastography,TEG)检测。术后1~7 d每天行双下肢深静脉超声检查,根据是否有DVT形成将患者分为血栓组(n=13)及非血栓组(n=128)。采用t检验及秩和检验比较两组患者临床资料,χ2检验和秩和检验比较两组TEG主要检测指标(如反应时间、凝固时间等)。应用logistic回归分析筛选患者术后DVT形成的危险因素。结果: 两组患者术后TEG指标R值、凝血因子功能、术中出血量、是否患高血压、术后住院天数和术后绝对卧床时间差异有统计学意义(P<0.05)。Logistic回归分析显示术后凝血因子功能亢进、术中出血量多和术后绝对卧床时间长为术后DVT形成的危险因素。结论: 术后凝血因子功能亢进是开颅手术患者术后DVT形成的一个重要危险因素,可在一定程度上预测术后DVT的发生。.
Keywords: craniotomy; deep vein thrombosis; thrombelastography.