剖宫产术后下肢静脉血栓形成危险因素分析

摘要

目的 探讨剖宫产术后下肢深静脉血栓形成(DVT)的危险因素.方法 剖宫产术后2周内发生下肢DVT的病例55例为病例组,同一年度剖宫产患者中未发生下肢DVT者110例为对照组.对各组一般资料(包括年龄、BMI、吸烟史、饮酒史、体育锻炼史),实验室指标(包括血浆D-D、CRP、PLT)进行单因素分析,并将DVT作为因变量,单因素分析有统计学意义的项作为自变量,进行多因素Logistic回归(逐步法),分析剖宫产术后下肢DVT的危险因素.结果 (1)病例组年龄、BMI、吸烟及饮酒者所占比例均高于对照组,体育锻炼者所占比例低于对照组,2组间比较差异均有统计学意义(P＜0.05)；(2)病例组CRP＞ 10 mg/L及血浆D-D＞ 300 ng/ml者所占比例均高于对照组,2组间比较差异均有统计学意义(P＜0.05)；(3)多因素Logistic回归分析结果显示:年龄、吸烟史、CRP、血浆D-D及缺乏体育锻炼为剖宫产患者下肢DVT的危险因素(P＜0.05),其OR(95％ CI)分别为1.41 (1.10～1.80)、1.84(1.38 ～2.45)、1.73 (1.40～2.13)、1.75 (1.37～2.24)及1.40(1.11 ～1.77).结论 年龄、吸烟史、缺乏体育锻炼、D-D、CRP可能为剖宫产术后下肢DVT的危险因素.%Objective To discuss the risk factors of deep venous thrombosis (DVT) after the cesarean section.Methods The case group was composed of 55 patients with DVT within two weeks after the cesarean section from Jan,2002 to Mar,2012.The control group was composed of 110 patients without DVT after the cesarean section at the same time and in the same hospital.The general information including age,BMI,smoking history,drinking history and history of physical exercise and laboratory information including plasma D-D,CRP and PLT were analyzed by single factor methods.Besides,DVT were as dependent variable,and the relationship of DVT with the risk factors were analyzed with the multi factor logistic regression method.Results (1) Age,BMI,smoking,and the proportion of drinkers in the case group were higher than that in control group,the proportion of physical exercisers was lower than that in the control group,and the differences between the two groups have statistical significance (P ＜ 0.05) ; (2) CRP ＞ 10 mg/L and the plasma D-D ＞ 300 ng/ml proportion were higher in the case group than that in the control group,and the differences between the two groups have statistical significance (P ＜ 0.05) ; (3) The multi factor logistic regression analysis show that age,smoking history,CRP,plasma D-D and lack of physical exercise were the independent risk factors of lower limb DVT (P ＜0.05),OR (95％ CI) were 1.41 (1.10 ～1.80),1.84 (1.38 ～ 2.45) and 1.73 (1.40 ～ 2.13),1.75 (1.37 ～ 2.24) and 1.40 (1.11 ～ 1.77),respectively.Conclusion Age,smoking history,plasma D-D,CRP and lack of physical exercise may be the risk factors of lower limb deep venous thrombosis after cesarean section.