中国西北地区不同年龄段下肢骨折患者围手术期深静脉血栓形成发生率及D-二聚体的比较研究

摘要

Objective To compare the perioperative incidence of deep venous thrombosis (DVT) and level of plasma D-dimer between different ages in patients with lower limb fracture in Northwest China.Methods The data were retrospectively analyzed of the 1,185 patients with lower limb fracture in 5 provinces in Northwest China from July 2014 to March 2017.They were 583 males and 602 femals,with an average of 60.3 years(from 18 to 102 years).Of them,723 were from Shaanxi Province,148 from Gansu Province,137 from Qinghai Province,128 from Ningxia Hui Nationality Autonomous Regions and 49 from Xinjiang Uygur Autonomous Region.They were divided into a young group (≤44 years old) (n =288),a middle-aged group (from 45 to 59 years old) (n =256),a junior elderly group (from 60 to 74 years old) (n =263),and a senior elderly group (≥75 years old) (n =378).The incidences of perioperative deep venous thrombosis (DVT) and levels of plasma D-dimer were compared between the 4 age groups.Results The DVT incidences before and after operation in the young group were significantly lower than in the other 3 groups (P ＜ 0.05);the DVT incidence after operation in the middle-aged group was significantly lower than that in the junior elderly group (P ＜ 0.05).The pre-and post-operative levels of plasma D-dimer increased with the age of the patients;the pre-and post-operative levels of plasma D-dimer in the senior elderly group were significantly higher than in the other 3 groups (P ＜ 0.05).Conclusions The perioperative incidence of DVT was high in the elderly patients with lower limb fracture in Northwest China,peaking in the age range from 60 to 74 years old.The pre-and post-operative levels of plasma D-dimer increased with the age of the patients.%目的 比较我国西北部地区不同年龄段下肢骨折患者围手术期深静脉血栓形成(DVT)发生率及D-二聚体水平.方法 回顾性分析2014年7月至2017年3月我国西北5省1 185例下肢骨折患者资料,男583例,女602例;年龄18 ～102岁,平均60.3岁;其中陕西省723例,甘肃省148例,青海省137例,宁夏回族自治区128例,新疆维吾尔族自治区49例.按照年龄分为青年组(≤44岁)(n=288)、中年组(45～59岁)(n=256)、年轻老年组(60～74岁)(n=263)、老年组(≥75岁)(n =378).统计并比较不同年龄阶段DVT发生率及D-二聚体水平. 结果 术前、术后青年组的DVT发生率均低于中年组、年轻老年组、老年组,差异有统计学意义(P＜0.05);术后中年组的DVT发生率低于年轻老年组,差异有统计学意义(P＜0.05).术前、术后患者血浆D-二聚体水平均随年龄增加而逐渐递增;术前、术后老年组D-二聚体水平均高于青年组、中年组、年轻老年组,差异有统计学意义(P＜0.05). 结论 中国西北地区老年患者围手术期DVT发生率较高,以60 ～74岁年轻老年组DVT发生率最高.