住院患者静脉血栓栓塞症危险因素分析
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摘要
目的对内蒙古自治区人民医院住院VTE患者分析其危险因素。方法通过病例系统调取2013年1月至2017年12月住院的主诊及辅助诊断为VTE患者共210例,选择同等数量同时期住院患者作为对照组。通过对年龄、性别、手术史、高血压病、糖尿病、大手术、恶性肿瘤、肺心病、肺炎、心力衰竭、心肌梗死、静脉曲张、下肢肿胀、中心静脉置管、卧床时间、脑卒中及炎性肠病等进行统计分析,筛选VTE发生相关危险因素。结果两组患者统计分析显示年龄、大手术、手术史、恶性肿瘤、中心静脉置管、脑卒中、骨盆/下肢骨折、关节置换等差异有统计学意义(P<0.05)。结论年龄、大手术、手术史、恶性肿瘤、中心静脉置管、脑卒中、骨盆/下肢骨折、关节置换与VTE的发生相关。
Objective To analyze the risk factors of VTE patients hospitalized in the Inner Mongolia people' s hospital. Methods A total of 210 hospitalized patients with VTE who underwent primary and secondary diagnosis from January 2013 to December 2017 were enrolled in the case system, the same numbers of concurrent hospitalized patients were selected as the control group. Statistical analysis was made on age, sex, operation history, hypertension, diabetes, major surgery, malignant tumor, pulmonary heart disease, pneumonia, heart failure, myocardial infarction, varicose veins, lower limb swelling, central venous catheterization, bed time, stroke and inflammatory bowel disease, in order to screen for risk factors associated with VTE. Results The statistical analysis of two groups showed that age, major operation, operation history, malignant tumor, central venous catheterization, stroke, pelvis/lower limb fracture, and joint replacement were statistically significant(P<0.05). Conclusion These factors were related to the occurrence of VTE, including age, major operation, operation history, malignant tumor, central venous catheterization, stroke, pelvic/lower limb fracture and joint replacement.
Objective To analyze the risk factors of VTE patients hospitalized in the Inner Mongolia people' s hospital. Methods A total of 210 hospitalized patients with VTE who underwent primary and secondary diagnosis from January 2013 to December 2017 were enrolled in the case system, the same numbers of concurrent hospitalized patients were selected as the control group. Statistical analysis was made on age, sex, operation history, hypertension, diabetes, major surgery, malignant tumor, pulmonary heart disease, pneumonia, heart failure, myocardial infarction, varicose veins, lower limb swelling, central venous catheterization, bed time, stroke and inflammatory bowel disease, in order to screen for risk factors associated with VTE. Results The statistical analysis of two groups showed that age, major operation, operation history, malignant tumor, central venous catheterization, stroke, pelvis/lower limb fracture, and joint replacement were statistically significant(P<0.05). Conclusion These factors were related to the occurrence of VTE, including age, major operation, operation history, malignant tumor, central venous catheterization, stroke, pelvic/lower limb fracture and joint replacement.
引文
[1]中华医学会外科学分会血管外科学组.深静脉血栓形成的诊断和治疗指南(3版)[J].中华普通外科杂志,2017,32(9):807-812.
[2]张福先.静脉血栓栓塞症诊治的现代观与关注点[J].中华血管外科杂志,2016,1(1):9-12.
[3] Jha AK, Larizgoitia I, Auderalopez C, et al. The global burden of unsafe medical care:analytic modelling of observational studies[J]. Bmj Quality&Safety, 2013,22(10):809-815.
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[6] Ageno W, Agnelli G, Imberti D, et a1.Risk factors for venous thromboembolism in the elderly:results ofthe master registry[J]. Blood Coagul Fibrinolysis,2008,19(7):663-667.
[7]王晓芳,李笠,张运剑.1996—2015年北京积水潭医院住院肺血栓栓塞症患者临床流行病学特征及诊治变迁情况[J].中国全科医学,2017,20(24):3004-3007,3014.
[8] Carlin MN, Daneshpajouh A, Catino J, et al. Money well spent? A cost and utilization analysis of prophylactic inferior vena cava filter placement in high-risk trauma patients[J]. J Surg Res, 2017,220:105-111.
[9] Cafri G, Paxton EW, Chen Y, et al. Comparative Effectiveness and Safety of Drug Prophylaxis for Prevention of Venous Thromboembolism After Total Knee Arthroplasty[J]. J Arthroplasty, 2017, 32(11):3524-3528.
[10] Arnold PM, Harrop JS, Merli G, et al. Efficacy,Safety, and Timing of Anticoagulant Thromboprophylaxis for the Prevention of Venous Thromboembolism in Patients With Acute Spinal Cord Injury:A Systematic Review[J]. Global Spine J, 2017, 7(3 Suppl):138S-150S.
[11] White RH, Zhou H, Romano PS. Incidence of symptomatic venous thromboembolism after different elective or urgent surgical procedures[J]. Thromb Haemost,2003,90(3):446-455.
[12] Zwicker JI, Connolly G, Carrier M, et al. Catheterassociated deep vein thrombosis of the upper extremity in cancer patients:guidance from the SSC of the ISTH[J]. J Thromb Haemost, 2014,12(5):796-800.
[13] Amankwah EK, Atchison CM, Arlikar S, et a1. Risk factors for hospital-sssociated venous thromboembolism in the neonatal intensive care unit[J].Thromb Res, 2014,134(2):305-309.
[14] Qaseem A, Chou R, Humphrey LL, et al. Venous thromboembolism prophylaxis in hospitalized patients:a clinical practice guideline from the American College of Physicians[J]. Ann Intern Med, 2011,155(9):625-632.
[15] White RH, Gettner S, Newman JM, et a1. Predictors of rehospitalization for symptomatic venous thromboembolism after total hip arthroplasty[J]. N Engl J Med, 2000,343(24):1758-1764.
[16] Zhang ZH, Shen B, Yang J, et a1. Risk factors for venous thromboembolism of total hip arthroplasty and total knee arthroplasty:a systematic review of evidences in ten years[J]. BMC musculoskelet disord,2015,16(1):24.
[2]张福先.静脉血栓栓塞症诊治的现代观与关注点[J].中华血管外科杂志,2016,1(1):9-12.
[3] Jha AK, Larizgoitia I, Auderalopez C, et al. The global burden of unsafe medical care:analytic modelling of observational studies[J]. Bmj Quality&Safety, 2013,22(10):809-815.
[4] Yeo DX, Junnarkar S, Balasubramaniam S, et al. Incidence of Venous Thromboembolism and Its Pharmacological Prophylaxis in Asian General Surgery Patients:A Systematic Review[J]. World J Surg, 2015, 39(1):150-157.
[5] Naess IA, Christiansen SC, Romundstad P, et al. Incidence and mortality of venous thrombosis:a population-based study[J]. J Thromb Haemost, 2007,5(4):692-699.
[6] Ageno W, Agnelli G, Imberti D, et a1.Risk factors for venous thromboembolism in the elderly:results ofthe master registry[J]. Blood Coagul Fibrinolysis,2008,19(7):663-667.
[7]王晓芳,李笠,张运剑.1996—2015年北京积水潭医院住院肺血栓栓塞症患者临床流行病学特征及诊治变迁情况[J].中国全科医学,2017,20(24):3004-3007,3014.
[8] Carlin MN, Daneshpajouh A, Catino J, et al. Money well spent? A cost and utilization analysis of prophylactic inferior vena cava filter placement in high-risk trauma patients[J]. J Surg Res, 2017,220:105-111.
[9] Cafri G, Paxton EW, Chen Y, et al. Comparative Effectiveness and Safety of Drug Prophylaxis for Prevention of Venous Thromboembolism After Total Knee Arthroplasty[J]. J Arthroplasty, 2017, 32(11):3524-3528.
[10] Arnold PM, Harrop JS, Merli G, et al. Efficacy,Safety, and Timing of Anticoagulant Thromboprophylaxis for the Prevention of Venous Thromboembolism in Patients With Acute Spinal Cord Injury:A Systematic Review[J]. Global Spine J, 2017, 7(3 Suppl):138S-150S.
[11] White RH, Zhou H, Romano PS. Incidence of symptomatic venous thromboembolism after different elective or urgent surgical procedures[J]. Thromb Haemost,2003,90(3):446-455.
[12] Zwicker JI, Connolly G, Carrier M, et al. Catheterassociated deep vein thrombosis of the upper extremity in cancer patients:guidance from the SSC of the ISTH[J]. J Thromb Haemost, 2014,12(5):796-800.
[13] Amankwah EK, Atchison CM, Arlikar S, et a1. Risk factors for hospital-sssociated venous thromboembolism in the neonatal intensive care unit[J].Thromb Res, 2014,134(2):305-309.
[14] Qaseem A, Chou R, Humphrey LL, et al. Venous thromboembolism prophylaxis in hospitalized patients:a clinical practice guideline from the American College of Physicians[J]. Ann Intern Med, 2011,155(9):625-632.
[15] White RH, Gettner S, Newman JM, et a1. Predictors of rehospitalization for symptomatic venous thromboembolism after total hip arthroplasty[J]. N Engl J Med, 2000,343(24):1758-1764.
[16] Zhang ZH, Shen B, Yang J, et a1. Risk factors for venous thromboembolism of total hip arthroplasty and total knee arthroplasty:a systematic review of evidences in ten years[J]. BMC musculoskelet disord,2015,16(1):24.