Clinical Analysis Of Lower Extremity Deep Venous Thrombosis After Gastrointestinal Surgery

Background and ObjectiveDeep venous thrombosis of lower extremity(DVT)has become one of the most common postoperative complications after abdominal surgery.Because it is the main source of fatal pulmonary thromboembolism,so preventing the formation of lower limb DVT to reduce the incidence of pulmonary embolism is particularly important.Therefore,it is necessary to fully understand the clinical characteristics and influencing factors of DVT in the process of gradual change and formation of the lower limb.At present,the risk factors of deep venous thrombosis has been widely recognized,and all of the specialist adopt a unified control program in the diagnosis and treatment of deep venous thrombosis under the guidance of a more unified control program,but the overall control effect is not good.The effect of prevention or treatment of DVT effect vary greatly because of the difference of basic disease,surgery and therapeutic method in various clinical specialties.However,there is still a lack of research data on the characteristics of thrombosis and the high risk factors in gastrointestinal surgery.The purpose of this study is to investigate the clinical characteristics and risk factors of lower extremity deep venous thrombosis after gastrointestinal surgery,as to provide reference for improving the control effect of DVT in our department,and then put forward the measures of prevention and treatment,in order to lay the foundation for the popularization and application of the rapid rehabilitation.Material and methodsThis prospective study enrolled all patients with gastrointestinal diseases from November 2014 to August 2015 in the First Affiliated Hospital of Zhengzhou University.Color Doppler ultrasound was used for detecting lower extremity deep venous thrombosis by time period.There were 120 cases of the patients who met the criteria of the entry group.Statistic the incidence,time of occurrence,location and type of thrombosis.Peroperative,intraoperative and postoperative factors of patients with DVT was compared with those without LDVT to identify the main DVT risk factors by using SPSS22.0 software.Results1.The incidence rate of DVT was 40.8%(49/120)after gastrointestinal surgery.The asymptomatic type muscular venous thrombosis accounted for 98%(48/49)in the first diagnosis type of thrombosis,peroneal vein thrombosis was 2%(1/49).2.The incidence of thrombosis in the left lower limb was significantly higher than that in the right lower limb after gastrointestinal surgery.The incidence of thrombosis in the left lower limb accounted for 49%(24/49),the right lower limb accounted for 20.4%(10/49),and the both lower limbs accounted for 30.6%(15/49).3 The incidence time of postoperative thrombosis mainly concentrated in 5 days after gastrointestinal surgery.The venous thrombosis within 2 hours after surgery is the main type of lower limb thrombosis in the perioperative period,which accounted for 73.5%,including 35 cases of intermuscular venous thrombosis and 1 cases of peroneal vein thrombosis;The other 5 cases,3 cases,2 cases,2 cases and 1 cases intermuscular venous thrombosis were diagnosed by ultrasound at 6h,12 h,24h,72 h,120h after operation respectively.4.The general clinical data of the two groups showed that the average age,body mass index(BMI),and average postoperative D-dimer level of the thrombus group were higher than that of the non thrombus group(P<0.05).There was no significant difference in gender,preoperative triglyceride level,preoperative cholesterol level,D-dimer level,preoperative platelet level,postoperative platelet levels,postoperative serum calcium level and operation time between the two groups(P>0.05).5.Multiple logistic regression analysis results showed that age over 60 years,malignant tumor,overweight(BMI greater than or equal to 24Kg/ square meters),postoperative D-dimer levels increased >1mg/L,postoperative infection are closely related to lower extremity DVT(P<0.05).ConclusionAsymptomatic muscular venous thrombosis within 2 hours after surgery is the main type of lower limb thrombosis after gastrointestinal surgery.The incidence of left lower limb DVT was significantly higher than that of the right lower extremity.The elderly(aged >60 years),malignant tumor,postoperative infection,D-dimer levels increased >1mg/L,overweight is the independent risk factors for the formation of DVT in gastrointestinal surgery.