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李镜.术后ICU患者并发静脉血栓栓塞的凝血功能与CRP变化及危险因素分析[J].中国医药科学,2021,(4):159-161        基金项目:
术后ICU患者并发静脉血栓栓塞的凝血功能与CRP变化及危险因素分析
Analysis on the coagulation function, CRP changes and risk factors of postoperative ICU patients complicated with venous thromboembolism
  
DOI:
中文关键词:  [关键词] 重症加强护理病房;静脉血栓栓塞;C反应蛋白;凝血功能;危险因素
英文关键词:[Key words] Intensive care unit; Venous thromboembolism; C reactive protein; Coagulation function; Risk factor
作者单位
李镜 重庆市开州区人民医院重症医学科,重庆 405400 
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中文摘要:
      [摘要] 目的 分析和研究术后ICU患者并发静脉血栓栓塞(VTE)的凝血功能与C反应蛋白(CRP)变化情况及危险因素。 方法 回顾性分析2017年3月至2019年3月于重庆市开州区人民医院接受手术治疗并入住ICU科室的患者200例,根据是否并发静脉血栓栓塞将全部患者分为VTE组(并发静脉血栓栓塞,n=50)和对照组(未并发静脉血栓栓塞,n=150),对两组患者的CRP及凝血功能变化情况进行比较。使用Logistic回归分析术后ICU患者并发静脉血栓栓塞的危险因素。 结果 本研究中手术类型包括心胸外科、胃肠外科、骨科、泌尿外科、神经外科等,骨科术后并发静脉血栓栓塞的发生率最高。将两组患者的凝血功能中的纤维蛋白、D-二聚体和血清CRP进行比较,VTE组均明显高于对照组,差异有统计学意义(P<0.05)。两组患者年龄、既往病史、手术时间、卧床时间及输血量比较,差异有统计学意义(P<0.05),其中纤维蛋白原高、D-二聚体高、手术时间(>4 h)、存在既往病史均为ICU患者并发静脉血栓栓塞的独立危险因素。 结论 术后ICU患者并发静脉血栓栓塞的CRP呈明显上升趋势,且手术时间及卧床时间较长,临床应对上述指标加以重视,进行有效及时的护理干预,预防静脉血栓栓塞。
英文摘要:
      [Abstract] Objective To analyze and research the changes and risk factors of coagulation function and C-reactive protein (CRP) in postoperative ICU patients complicated with venous thromboembolism (VTE). Methods A retrospective analysis was conducted on 200 patients admitted to ICU department for surgical treatment in the People's Hospital of Kaizhou District from March 2017 to March 2019. All patients were divided into the VTE group (complicated with VTE, n=50) and the control (not complicated with VTE, group, n=150) according to whether they were complicated with VTE. The changes of CRP and coagulation function were compared between the two groups of patients. Logistic regression was used to analyze the risk factors of postoperative VTE in ICU patients. Results In this research, the types of operations include cardiothoracic surgery, gastrointestinal surgery, orthopedics, urology, neurosurgery, etc. The incidence of postoperative VTE in orthopedics was the highest. Fibrin, D-dimer and serum CRP in coagulation function between the two groups of patients were compared, and the VTE group was significantly higher than those in the control group, with statistically significant differences (P<0.05). There were significant differences in age,medical history, operation duration, bedtime and blood transfusion volume between the two groups of patients (P < 0.05), among which high fibrinogen, high D-dimer, operation duration ( > 4 h) and previous medical history were independent risk factors of ICU patients complicated with VTE. Conclusion After operation, the CRP of ICU patients complicated with VTE indicates an obvious upward trend, and the operation duration and bedtime are longer. Therefore, the above indexes should be paid attention to in clinic, and effective and timely nursing intervention should be carried out to prevent VTE.
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