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.
作者
张沫
蒋仁莲
吴修建
周书娅
邵高海
ZHANG Mo;JIANG Renlian;WU Xiujian;ZHOU Shuya;SHAO Gaohai(Orthopedic Trauma,Yongchuan Hospital Affiliated to Chongqing Medical University,Chongqing 402160,China;School of Nursing,Chongqing Medical University,Chongqing 400010,China;Department of Nursing,Yongchuan Hospital Affiliated to Chongqing Medical University,Chongqing 402160,China)
出处
《现代医学》
2024年第2期254-260,共7页
Modern Medical Journal
基金
重庆市技术创新与应用发展专项重点项目(CSTB2022TIAD-KPX0172)。
关键词
转子间骨折
髋部骨折
深静脉血栓
围术期
危险因素
META分析
intertrochanteric fractures
hip fractures
deep venous thrombosis
perioperative period
risk factors
Meta-analysis
