口腔颌面外科术后下肢深静脉血栓形成危险因素的病例对照研究

摘要

目的：探讨口腔颌面外科术后下肢深静脉血栓（DVT）形成的危险因素。方法采用病例对照研究方法，以2010年1月—2014年12月在新疆医科大学第一附属医院颌面外科和喀什地区第一人民医院颌面外科术后发生下肢深静脉血栓患者为病例组（n ＝40例），随机选择同期、同院接受同类颌面外科手术但术后未发生深静脉血栓患者为对照组（n ＝46例）。收集两组患者的病历、相关人口学及临床资料。并采用单因素及多因素非条件logistic 回归模型分析口腔颌面外科术后深静脉血栓发生的影响因素。结果多因素 logistic 回归分析显示，年龄（OR ＝1．10，95％ CI ：1．02～1．96）、术后 D-二聚体（OR ＝1．87，95％ CI ：1．18～2．95）、高血压（OR ＝1．46，95％ CI ：1．12～1．75）和恶性肿瘤（OR ＝6．43，95％ CI ：3．22～24．34）与颌面外科术后下肢深静脉血栓形成有关。结论恶性肿瘤、高血压和高龄是颌面外科术后下肢深静脉血栓形成的易感因素，D-二聚体对下肢 DVT 的形成具有预警价值。%Objective To explore the risk factors of deep venous thrombosis (DVT)among patients after receiving oral and maxillofacial surgery.Methods This study applied the case-control study design.Cases were 40 patients diagnosed with DVT after receiving oral and maxillofacial surgery in Xinjiang Medical U-niversity First Affiliated Hospital and Kashi Prefecture the First People's Hospital of Departments of Oral and Maxillofacial Surgery between January in 2010 and December in 2014.Controls were 46 random pa-tients without DVT after receiving same surgery during the same period in the same hospital with cases. Demographic and clinical data were collected by investigating the medical records,which was analyzed by using univariate and multivariate logistic regression models.Results Multivariate logistic regression anal-ysis showed that age (OR =1.10,95% CI :1.02-1.96),post-operational D-dimer (OR =1.87,95% CI :1.18- 2.95 ),malignant tumor (OR = 6.43,95% CI :3.22 - 24.34)and hypertension (OR = 1.46, 95% CI :1.12-1.75)were risk factors of DVT in patients after receiving oral and maxillofacial surgery. Conclu-sion Malignant tumor,hypertension and older age increase the risk of DVT among patients after receiving oral and maxillofacial surgery.Additionally,D-dimer can be used to predict DVT after surgery.