Analysis Of Related Factors Of Lower Extremity Deep Venous Thrombosis Occurrance After Operation Of Femoral Neck Fracture

Objectives To analyze the incidence and location of the lower extremity deep vein thrombosis(LDVT)after femoral neck fracture in my department during the last three years,and to further explain the causes of LDVT and explore the correlation between related factors and LDVT.Methods Rigorous formulation of inclusion criteria and exclusion criteria,collecting and selecting qualified medical records for retrospective study.Time--January 2015 to December 2017;Object-413 patients with concurrent surgical treatment of femoral neck fracture with inclusion criteria.Data collected and collated include:(1)general information about the patient's admission,including the patient's name,age,gender,BMI,and the combination of diseases and other basic information.(2)after admission test of laboratory data,including after admission and postoperative regularly check blood glucose,serum triglycerides(TG),serum total cholesterol(CHOL),blood sedimentation,coagulation four,D-Dimer and other indicators of dynamic test.(3)related information of the operation: selection of surgical methods,duration of operation,anesthesia methods and other information.(4)the status of the bi-lower limb vein color ultrasonography,and whether the blood thrombus and thrombus location,type and other details were included.According to the choice of surgical method,male,female,age and blood glucose,TG,CHOL,whether the abnormality was divided into groups;Through SPSS 17.0 statistical software for data analysis,according to the variable data attribute,measurement data to compare the mean using t test,incidence of count data using X2 test,postoperative concurrent interpretation of LDVT and the relationship between the related factors,adopts the unconditioned Logistic regression model,if P < 0.05,the difference was statistically significant.Results In this study,413 patients were selected after the exclusion criteria and inclusion criteria were selected.After careful statistics,107 patients with LDVT were postoperative and the incidence rate was 25.91%.The incidence of LDVT after femoral neck fracture was: closed reduction of hollow nail internal fixation: 17.58%;Bipola Femeral Head Replacement(BFHR): 26.38%;Total Hip Replacement(THR): 35.29%.Thromboembolic vein;There were 53 cases(49.53%)of intramuscular vein(49.53%),12 cases(11.21%)of the peroneal vein,8 cases(7.48%)of the posterior tibial vein(7.48%),and 34 cases(31.77%)were embolised at the same time,and no progress was made in the case of pulmonary thromboembolism.Logistic regression analysis showed that male was the reference,female(P=0.047,B=0.604,OR=1.829,95%CI: 1.008-3.318);Smoking(P=0.001,B=1.217,OR=3.375,95%CI: 1.641-6.943);In combination with medical disease,?2 as the reference,and the merger of medical diseases>2(P=0.031,B=0.560,OR=1.751,95%CI: 1.053-2.910);The normal value of serum triglyceride was the reference.The serum triglyceride(P=0.024,B=0.783,OR=2.187,95%CI: 1.111-3.307)The normal value of Blood glucose was the reference,Blood glucose(P=0.008,B=0.726,OR=2.066,95%CI: 1.214-3.517);Combined anesthesia with lumbar spine(P=0.000,B=1.441,OR=4.226,95%CI: 2.434-7.337);For reference,double pole artificial femoral head replacement group(P=0.012,B=1.231,OR=3.425,95%CI: 1.309-8.958),artificial total hip replacement group(P=0.040,B=0.713,OR=2.039,95%CI: 1.034-4.022);The operation time was less than 45 minutes was the reference,The operation time was 45-60 minutes(P=0.004,B=1.152,OR=3.166,95%CI: 1.451-6.906),The operation time was>60 minutes group(P=0.011,B=0.862,OR=2.367,95%CI: 1.216-4.608);Wait for operation time <5 days for reference,waiting for operation time?5 days(P=0.014,B=0.668,OR=1.950,95%CI: 1.144-3.325).Female,smoking,merger of medical diseases>2,serum triglyceride,blood glucose,combined anesthesia,surgical method,operation time,and waiting operation time ?5 days OR>1,which may be the risk factor of LDVTConclusions(1)The incidence of LDVT in patients with femoral neck fracture is about 17.58% to 35.29%,the average incidence rate of 25.91%.(2)Postoperative LDVT was reduced from low to high in order: closed reduction hollow screw internal fixation group,BFHR group,THR group.(3)The combination of more than 2 diseases is the risk factor of LDVT.(4)The incidence of female is higher than that of men.(5)Waiting times for operations time?5-day group the incidence rate of LDVT was higher than that the other group.(6)TG,blood glucose and hydrostatic anesthesia are the risk factors of LDVT.