股骨转子间骨折患者围术期发生DVT危险因素的Meta分析-现代医学

股骨转子间骨折患者围术期发生DVT危险因素的Meta分析

单位：1. 重庆医科大学附属永川医院骨科创伤, 重庆 402160;
2. 重庆医科大学护理学院, 重庆 400010;
3. 重庆医科大学附属永川医院护理部, 重庆 402160

分类号：R816.8

出版年·卷·期（页码）：2024·52·第二期（254-260）

摘要：

目的：通过Meta分析了解股骨转子间骨折患者围术期发生深静脉血栓(DVT)的危险因素，为临床早期识别和预防DVT提供针对性干预措施。方法： 计算机检索中国知网(CNKI)、万方数据库、中国生物医学文献数据库(CBM)、PubMed、Web of Science、Cochrane Library，检索时限为建库至2022年12月1日，使用Stata17.0软件进行Meta分析。结果：共纳入13篇文献，提取25项相关危险因素，Meta分析结果显示，女性(OR=1.81，95%CI 1.24～2.63)、肥胖(OR=3.02，95%CI 2.10～4.34)、骨折至入院时间延长(OR=1.28，95%CI 1.12～1.45)、术前D-二聚体水平增高(OR=1.94，95%CI 1.57～2.38)、白蛋白水平降低(OR=1.68，95%CI 1.43～1.97)、糖尿病(OR=2.05，95%CI 1.40～2.98)、合并症数量≥3个(OR=2.16，95%CI 1.36～3.42)、既往有静脉血栓栓塞症(VTE)病史(OR=3.01，95%CI 3.00～3.03)、合并周围血管疾病史(OR=2.68，95%CI 1.46～4.94)是股骨转子间骨折患者围术期发生DVT的危险因素。结论：股骨转子间骨折患者围术期发生DVT的危险因素较多，但所纳入文献均为回顾性病例对照研究，因此今后还需开展大样本、多中心的前瞻性队列研究。

Objective: To understand the risk factors of perioperative deep venous thrombosis(DVT) in patients with intertrochanteric fractures by Meta-analysis， and to provide targeted interventions for early identification and prevention of DVT in clinic. Methods: Computerized searches were performed on China Knowledge Network(CNKI), Wanfang database, China Biomedical Literature Database(CBM), PubMed, Web of Science, Cochrane Library, with a search timeframe from the establishment of the database to December 1, 2022, and Meta-analysis was performed using Stata 17.0 software. Results: A total of 13 studies were included and 25 relevant risk factors were extracted， the results of Meta-analysis showed that female(OR=1.81,95%CI 1.24-2.63),obesity(OR=3.02,95%CI 2.10-4.34),prolonged fracture-to-admission time(OR=1.28,95%CI 1.12-1.45),preoperative D-dimer level elevated(OR=1.94,95%CI 1.57-2.38),albumin level decreased(OR=1.68,95%CI 1.43-1.97), diabetes mellitus(OR=2.05,95%CI 1.40-2.98),and number of comorbidities≥3(OR=2.16,95%CI 1.36-3.42),previous history of venous thromboembolism(OR=3.01,95%CI 3.00-3.03),and history of comorbid peripheral vascular disease(OR=2.68,95%CI 1.46-4.94) were risk factors for the development of DVT in the perioperative period of intertrochanteric fractures. Conclusion: There are more risk factors for perioperative DVT in patients with intertrochanteric fractures,but the included literature are retrospective case-control studies,so prospective cohort studies with large samples and multicenter are needed in the future.

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