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目的探讨口腔颌面外科术后下肢深静脉血栓(DVT)形成的危险因素。方法采用病例对照研究方法,以2010年1月—2014年12月在新疆医科大学第一附属医院颌面外科和喀什地区第一人民医院颌面外科术后发生下肢深静脉血栓患者为病例组(n=40例),随机选择同期、同院接受同类颌面外科手术但术后未发生深静脉血栓患者为对照组(n=46例)。收集两组患者的病历、相关人口学及临床资料。并采用单因素及多因素非条件logistic回归模型分析口腔颌面外科术后深静脉血栓发生的影响因素。结果多因素logistic回归分析显示,年龄(OR=1.10,95%CI:1.02~1.96)、术后D-二聚体(OR=1.87,95%CI:1.18~2.95)、高血压(OR=1.46,95%CI:1.12~1.75)和恶性肿瘤(OR=6.43,95%CI:3.22~24.34)与颌面外科术后下肢深静脉血栓形成有关。结论恶性肿瘤、高血压和高龄是颌面外科术后下肢深静脉血栓形成的易感因素,D-二聚体对下肢DVT的形成具有预警价值。
Objective To investigate the risk factors for the formation of deep vein thrombosis (DVT) after oral and maxillofacial surgery. Methods A case-control study was conducted in January 2010-December 2014 in the Department of Maxillofacial Surgery, the First Affiliated Hospital of Xinjiang Medical University and the patients with lower extremity deep venous thrombosis after maxillofacial surgery in First People’s Hospital of Kashgar Prefecture. n = 40 cases). Patients in the same hospital, who underwent maxillofacial surgery in the same period but did not develop deep venous thrombosis after surgery were selected as the control group (n = 46). The two groups of patients were collected medical records, relevant demography and clinical data. Univariate and multivariate non-conditional logistic regression models were used to analyze the influencing factors of deep venous thrombosis after oral and maxillofacial surgery. Results Multivariate logistic regression analysis showed that age (OR = 1.10, 95% CI: 1.02-1.96), postoperative D-dimer (OR = 1.87, 95% CI: 1.18-2.95) , 95% CI: 1.12-1.75) and malignant tumors (OR = 6.43, 95% CI: 3.22-24.34) were associated with lower extremity deep vein thrombosis after maxillofacial surgery. Conclusion Malignant tumor, hypertension and advanced age are susceptible factors of deep venous thrombosis of lower extremity after maxillofacial surgery. D-dimer has an early warning value for the formation of DVT of lower extremity.