临床麻醉学杂志2024,Vol.40Issue(1) :56-60.DOI:10.12089/jca.2024.01.011

全麻患者术后麻醉重症监护室中新发下肢深静脉血栓的危险因素

Risk factors for newly developed lower extremity deep vein thrombosis in patients after general anes-thesia in the anesthesia intensive care unit

王晓飞 孙铭阳 张加强
临床麻醉学杂志2024,Vol.40Issue(1) :56-60.DOI:10.12089/jca.2024.01.011

全麻患者术后麻醉重症监护室中新发下肢深静脉血栓的危险因素

Risk factors for newly developed lower extremity deep vein thrombosis in patients after general anes-thesia in the anesthesia intensive care unit

王晓飞 1孙铭阳 1张加强1
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作者信息

  • 1. 450003 郑州市,河南省人民医院麻醉与围术期医学科
  • 折叠

摘要

目的 筛选全麻术后转入麻醉重症监护室(AICU)的患者新发下肢深静脉血栓(DVT)的危险因素.方法 回顾性收集 2022 年 5-8月择期行全麻下手术后带气管插管转入AICU的患者192 例,男 105 例,女 87 例,年龄 18~85 岁,BMI 18~31 kg/m2,ASA Ⅱ或Ⅲ级.收集患者基线资料、麻醉手术资料及实验室检查资料.根据入AICU 6 h内的超声结果是否有新发DVT将患者分为两组:DVT组和非DVT组.采用多因素Logistic回归分析筛选AICU中患者术后 6h内新发DVT的危险因素及其 95%可信区间(CI).结果 全麻术后在AICU新发DVT的患者有 64 例(33.3%),均为小腿肌间静脉血栓(CMVT).多因素Logistic回归分析结果显示,术前心律失常(OR=2.236,95%CI 1.011~4.943,P=0.047)、术前血小板计数高(OR= 1.006,95%CI 1.002~1.010,P= 0.007)、术前D-二聚体浓度高(OR= 1.203,95%CI 1.046~1.383,P= 0.010)、术中低血压(OR= 1.010,95%CI 1.002~1.019,P=0.020)和术中应用去甲肾上腺素(OR=3.796,95%CI 1.697~8.492,P=0.001)是全麻术后AICU 中患者新发 DVT 的危险因素;阿司匹林规律服用史(OR= 0.176,95%CI 0.060~0.518,P=0.002)是其保护因素.结论 术前心律失常、术前血小板计数高、术前D-二聚体浓度高、术中低血压及术中应用去甲肾上腺素是全麻手术后AICU患者 6h内新发DVT的危险因素.

Abstract

Objective To identify the risk factors for newly developed lower extremity deep vein thrombosis(DVT)in patients transferred to the anesthesia intensive care unit(AICU)after general anes-thesia.Methods A total of 192 patients who were transferred to AICU with tracheal intubation after elective general anesthesia from May 2022 to August 2022,105 males and 87 females,aged 18-85 years,BMI 18-31 kg/m2,ASA physical status Ⅱor Ⅲ,were retrospectively collected.The patients'baseline da-ta,anesthesia surgery data and preoperative and postoperative laboratory examination data were obtained.The patients were divided into two groups according to the results of ultrasound within 6 hours after admission to the AICU:DVT group and non-DVT group.Multivariate logistic regression analysis was used to analyze the risk factors and 95%confidence interval(CI)of DVT in AICU patients within 6 hours after sur-gery.ResultsNew DVT occurred in 64 patients(33.3%)in AICU after general anesthesia were calf inter-muscular venous thrombosis(CMVT).Multivariate logistic regression analysis showed that preoperative ar-rhythmia(OR = 2.236,95%CI 1.011-4.943,P = 0.047),high preoperative platelet count(OR = 1.006,95%CI 1.002-1.010,P = 0.007),high preoperative D-dimer concentration(OR=1.203,95%CI 1.046-1.383,P = 0.010),intraoperative hypotension(OR = 1.010,95%CI 1.002-1.019,P = 0.020),and intraoperative norepinephrine application(OR = 3.796,95%CI 1.697-8.492,P = 0.001)were risk factors for new DVT formation in AICU patients after general anesthesia.History of regular intake of aspirin(OR = 0.176,95%CI 0.060-0.518,P = 0.002)was protective factor.Conclusion Preoperative arrhythmia,high preoperative platelet count,high preoperative D-dimer concentration,intraop-erative hypotension,and administration of intraoperative norepinephrine are risk factors for new DVT within 6 hours after general anesthesia in AICU patients.

关键词

下肢深静脉血栓/全麻/麻醉重症监护室/危险因素

Key words

Lower extremity deep vein thrombosis/General anesthesia/Anesthesia intensive care unit/Risk factors

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出版年

2024
临床麻醉学杂志
中华医学会南京分会

临床麻醉学杂志

CSTPCD北大核心
影响因子:2.225
ISSN:1004-5805
被引量1
参考文献量4
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