术中输血与老年神经外科病人术后下肢深静脉血栓形成的关系研究

doi:10.3969/j.issn.1003-9198.2025.10.010

摘要/Abstract

摘要： 目的分析术中输血对老年神经外科病人术后下肢深静脉血栓形成(DVT)的影响。方法回顾性分析2023年1月至2024年11月在长海医院行神经外科手术的352例老年病人的临床资料。根据术中是否输血分为输血组(82例)、未输血组(270例),比较2组临床资料及术后DVT发生率。另外,按照术后是否发生下肢DVT将所有病人分为DVT组(104例)和非DVT组(248例),采用多因素logistic回归分析下肢DVT发生的独立影响因素。结果输血组ASA分级、术后纤维蛋白酶原水平与未输血组比较,差异有统计学意义(P＜0.05)。352例病人下肢DVT发生率为29.55%(104/352),输血组下肢DVT发生率高于未输血组(45.12% 比 24.81%,P＜0.001)。多因素logistic回归分析显示,调整年龄、高血压、脱水剂使用情况、长期卧床、合并恶性肿瘤、术后D-二聚体水平等因素后,输血者相对于未输血者,发生下肢DVT的风险增高(OR=2.502,95%CI:1.357～4.613,P＜0.05)。结论术中输血是老年神经外科病人术后发生下肢DVT的独立危险因素。

关键词: 术中输血, 老年人, 神经外科, 深静脉血栓形成, 下肢

Abstract: Objective To analyze the effect of intraoperative blood transfusion on deep venous thrombosis (DVT) of lower limbs in the elderly patients after neurosurgery. Methods The clinical data of 352 elderly patients who underwent neurosurgery in Changhai Hospital from January 2023 to November 2024 were retrospectively analyzed. According to whether intraoperative blood transfusion was performed, the patients were divided into blood transfusion group (82 cases) and non-blood transfusion group (270 cases). The clinical data and the incidence of postoperative DVT were compared between the two groups. In addition, the patients were divided into DVT group (104 cases) and non-DVT group (248 cases) according to whether DVT occurred in the lower limbs after operation. Univariate and multivariate logistic regression analysis was used to analyze the independent risk factors for DVT in the lower limbs. Results There were significant differences in American Society of Aneshesiologists (ASA ) classification and postoperative fibrinogen level between blood transfusion group and non-blood transfusion group (P<0.05). The incidence of DVT in 352 patients was 29.55% (104/352), and the incidence of DVT in blood transfusion group was higher than that in non-blood transfusion group (45.12% vs 24.81%, P<0.001). Multivariate logistic analysis showed that after adjusting age, hypertension, dehydrating agent use, prolonged bed rest, comorbid malignancy, postoperative D-dimer level, the risk of DVT in blood transfusion patients was higher than that in non-blood transfusion patients (OR=2.502, 95%CI: 1.357-4.613, P<0.05). Conclusions Intraoperative blood transfusion is an independent risk factor for postoperative DVT of lower limb in the elderly patients undergoing neurosurgery.

Key words: intraoperative blood transfusion, aged, neurosurgery, deep vein thrombosis, lower limbs

中图分类号:

R 457.13

王玲, 仇文, 巩晓珊. 术中输血与老年神经外科病人术后下肢深静脉血栓形成的关系研究[J]. 实用老年医学, 2025, 39(10): 1019-1023.

WANG Ling, QIU Wen, GONG Xiaoshan. Correlation between intraoperative blood transfusion and postoperative deep venous thrombosis of lower limb in elderly patients after neurosurgery[J]. Practical Geriatrics, 2025, 39(10): 1019-1023.

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