机械通气患者深静脉血栓的发病率和危险因素分析

doi:10.3969/j.issn.1006-5253.2022.01.004

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摘要目的探讨机械通气患者深静脉血栓（DVT）的发病率和危险因素。方法收集2019年1月至2019年12月入住浙江大学医学院附属金华医院急诊监护室机械通气患者临床资料，记录患者的静脉血栓预防措施、深静脉血栓发病率、发病时间、ICU住院时间、90 d全因病死率等，采用多因素logistic回归分析评估患者发生深静脉血栓的独立危险因素。结果共收集200例机械通气患者，平均年龄（59.3±16.8）岁，APACHEⅡ评分中位数19(14,24)分，Caprini 2009评分中位数8(6,10)分，ICU住院时间中位数9(5,18) d，90 d全因病死率24.5%，DVT发病率23.0%，发病时间中位数为入ICU后7(4,13) d。多因素logistic回归分析显示患者的年龄（OR=1.029，95% CI：1.005～1.055)，ICU住院时间（OR=1.057，95%CI：1.033～1.082)是ICU患者发生DVT的影响因素。结论 ICU中的机械通气患者是DVT高危人群，DVT组患者的ICU住院时间明显延长。患者年龄和ICU的住院时间是DVT风险增加的独立影响因素。

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	楼小华
	章炳文
	景道远

关键词 ：机械通气, 深静脉血栓, 发病率, 危险因素

Abstract：Objective To explore the incidence and risk factors of deep vein thrombosis(DVT) in invasive mechanically ventilated patients.Methods Clinical data of mechanical ventilation patients admitted to the Emergency Care Unit of Jinhua Hospital Affiliated to Zhejiang University School of Medicine from January 2019 to December 2019 were collected, and the preventive measures of venous thrombosis, incidence of deep venous thrombosis, onset time, length of ICU stay, and 90-day all-cause mortality rate of the patients were recorded. Multivariate logistic regression analysis was used to assess the independent risk factors for DVT. Results Two hundred mechanically ventilated patients with a mean age of (59.3±16.8) years old, a median APACHEⅡ score of 19(14,24), a median Caprini 2009 score of 8(6,10), a median ICU length of stay of 9 (5,18) days, and a 90-day all-cause mortality rate of 24.5%. The incidence of DVT was 23.0%, and the median time of onset was 7(4,13) days after ICU admission. Multivariate Logistic regression analysis showed that patient′s age (OR=1.029, 95% CI: 1.005-1.055), and length of ICU stay (OR=1.057, 95% CI: 1.033-1.082) were independent risk factors for the development of DVT in ICU patients. Conclusion Patients receiving mechanical ventilation in the ICU are at high risk for DVT, and patients with DVT had significantly longer ICU stays. Independent risk factors for DVT were age and length of ICU stay.

Key words： mechanical ventilation deep vein thrombosis incidence risk factor

收稿日期: 2022-02-04

通讯作者: 楼小华，Email：louxiaohua_1984@163.com

引用本文:

楼小华，章炳文，景道远. 机械通气患者深静脉血栓的发病率和危险因素分析[J]. 中国医院统计, 2022, 29(1): 18-24.
Lou Xiaohua, Zhang Bingwen, Jing Daoyuan. Deep venous thrombosis in invasive mechanically ventilated patients: incidence and risk factors. journal1, 2022, 29(1): 18-24.

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