摘要
目的 总结腰椎融合术后静脉血栓栓塞症的危险因素,为临床识别和预防提供循证医学证据.方法 检索PubMed、Embase、Cochrane Library、Web of Science、CNKI、WanFang Data、VIP和CBM数据库,搜集建库至2021 年 5 月 3 日关于腰椎融合术后静脉血栓栓塞症的危险因素的研究.由2 位研究者独立进行文献筛选、资料提取和质量评估,采用RevMan 5.4软件进行数据分析.结果 共纳入22 篇文献,累计 3259845 例,其中 21320 例患者发生静脉血栓栓塞症.Meta分析结果显示,腰椎融合术后VTE的危险因素为:高龄[OR=8.91,95%CI(7.65～10.18)],吸烟[OR=1.72,95%CI(1.03～2.88)],高血压[OR=2.07,95%CI(1.64～2.60)],糖尿病[OR =1.30,95%CI(1.24～1.35)],抗凝药的使用[OR =1.64,95%CI(1.01～2.65)],多节段融合[OR=3.07,95%CI(1.53～6.18)],前路腰椎融合术[OR =1.49,95%CI(1.34～1.66)],手术时间≥3h[OR=1.60,95%CI(1.13～2.27)],输血[OR=3.98,95%CI(2.34～6.77)],D-二聚体≥500 ug/L[OR =2.33,95%CI(1.53～3.54)].运动锻炼[OR=0.43,95%CI(0.30～0.60)]是腰椎融合术后静脉血栓栓塞症的保护因素.结论 通过Meta分析发现,高龄、吸烟、高血压史、抗凝药的使用、多节段融合、前路手术、手术时间≥3 h、输血、D-二聚体是腰椎融合术后静脉血栓栓塞症的危险因素,而运动锻炼是其保护因素.
Abstract
Objective To summarize the risk factors for venous thromboembolism after lumbar fusion,and provide evidence-based medical evidence for clinical identification and prevention of venous thromboembolism after lumbar fusion.Methods PubMed,Em-base,Cochrane Library,Web of Science,CNKI,WanFang Data,VIP,and CBM databases were searched,and studies were collected until May 3,2021 on the risk factors of venous thromboembolism after lumbar fusion.Two researchers independently carried out litera-ture screening,data extraction and quality assessment,and RevMan5.4 software was used for data analysis.Results A total of 22 ar-ticles were included,and the cumulative number of patients was 3,259,845,of which 21,320 patients developed venous thromboembo-lism.Meta-analysis results showed that the risk factors for VTE after lumbar fusion were:advanced age[OR=8.91,95％CI(7.65～10.18)],smoking[OR=1.72,95％CI(1.03～2.88)],hypertension[OR =2.07,95％CI(1.64～2.60)],diabetes[OR = 1.30,95％CI(1.24～1.35)],use of anticoagulants[OR=1.64,95％CI(1.01～2.65)],multi-segment fusion[OR=3.07,95％CI(1.53～6.18)],anterior lumbar fusion[OR=1.49,95％CI(1.34～1.66)],operation time≥3 h[OR =1.60,95％CI(1.13～2.27)],blood transfusion[OR=3.98,95％CI(2.34～6.77)],D-dimer≥500 ug/L[OR=2.33,95％CI(1.53～3.54)].Ex-ercise[OR=0.43,95％CI(0.30～0.60)]was a protective factor for venous thromboembolism after lumbar fusion.Conclusion Me-ta-analysis finds that old age,smoking,history of hypertension,use of anticoagulants,multi-segment fusion,anterior surgery,opera-tion time≥3 h,blood transfusion,D-dimer≥500 ug/L are the risk factors of venous thromboembolism after lumbar fusion.The pro-tective factor of venous thromboembolism after lumbar fusion is exercise.
维普
万方数据