股骨颈骨折术前深静脉血栓发生因素的荟萃分析

A meta-analysis on risk factors for preoperative deep vein thrombosis in femoral neck fractures

摘要:

[目的]分析股骨颈骨折患者术前下肢深静脉血栓发生的因素。[方法]检索中国生物医学文献数据库、中国知网、 万方、Pubmed、Embase 建库到 2024 年 5 月，提取符合标准的文献资料，利用 RevMan5.3 软件分析。[结果] 共纳入 9 篇文献，均为病例对照研究，涉及术前深静脉血栓患者 803 例，非深静脉血栓患者 3 611 例。荟萃分析结果显示：年龄（MD=1.98, 95%CI: 0.28~3.68, P=0.02）、受伤至入院时间＞1 d （OR=1.70, 95%CI: 1.39~2.08, P＜0.001）、吸烟史 （OR=1.56, 95%CI: 1.18~2.05, P=0.002）、高血压病史（OR=1.21, 95%CI: 1.03~1.42, P=0.02）、血清白蛋白＜35 g/L（OR=1.69, 95%CI: 1.30~2.20, P＜0.001）、血清 D-二聚体≥0.5 mg/L （OR=1.70, 95%CI: 1.03~2.78, P=0.04）、ASA 分级≥Ⅲ级 （OR=4.34, 95%CI: 1.42~13.26, P=0.01）、全血血小板计数≥262×109 /L （OR=2.34, 95%CI: 1.78~3.08, P＜0.001）是股骨颈骨折患者术前下肢深静脉血栓发生的危险因素。[结论]年龄、受伤至入院时间＞1d、吸烟史、高血压病史、血清白蛋白＜35 g/L、血清 D-二聚体≥0.5 mg/L、全血血小板计数≥262×109 /L、 ASA 分级≥Ⅲ级是股骨颈骨折患者发生术前下肢深静脉血栓的危险因素。应对具有上述危险因素的患者给予高度关注，降低术前下肢深静脉血栓的发生率。

Abstract:

[Objective] To analyze the risk factors for deep vein thrombosis (DVT) in the lower extremity before surgery for femoral neck fracture. [Methods] The databases, including China Biomedical Literature Database, CNKI, Wanfang, Pubmed and Embase, were searched to May 2024, and the literature that met the standards was extracted and analyzed by RevMan5.3 software. [Results] A total of 9 studies were included, all of which were case-control studies, involving 803 patients with DVT and 3 611 patients without DVT. As results of meta-analysis, the age (MD=1.98, 95%CI: 0.28~3.68, P=0.02), interval from injury to hospitalization ＞1 day (OR=1.70, 95%CI: 1.39~ 2.08, P＜0.001), smoking history (OR=1.56, 95%CI: 1.18~2.05, P=0.002), history of hypertension (OR=1.21, 95%CI: 1.03~1.42, P=0.02), serum albumin＜35 g/L (OR=1.69, 95%CI: 1.30~2.20, P＜0.001), serum D-dimer ≥0.5 mg/L (OR=1.70, 95%CI: 1.03~2.78, P=0.04), ASA grade ≥ grade III. (OR=4.34, 95%CI: 1.42~13.26, P=0.01), whole blood platelet count ≥262×109 / L (OR=2.34, 95%CI: 1.78~3.08, P＜ 0.001) were risk factors for development of DVT in the lower extremity before surgery in patients with femoral neck fracture. [Conclusion] Age, time interval from injury to hospitalization ＞1 day, history of smoking, history of hypertension, serum albumin ＜35 g/L, serum D-dimer ≥0.5 mg/L, whole blood platelet count ≥ 262×109 /L, and ASA grade ≥ III are risk factors for preoperative lower extremity DVT in patients with femoral neck fracture, which should be given a high degree of attention to reduce the incidence of the incidence.