急性脊柱损伤患者发生肺栓塞的危险因素分析

李伊敬; 鄢苏鹏; 邵艳霞; 袁媛; 蒋春梅; 蒲淑玉; 孙溦

doi:10.16016/j.2097-0927.202404064

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急性脊柱损伤患者发生肺栓塞的危险因素分析

临床医学 | 更新时间：2026-01-09

- 急性脊柱损伤患者发生肺栓塞的危险因素分析
- Risk factors for pulmonary embolism in patients with acute spinal cord injury
- 陆军军医大学学报 2024年46卷第18期页码：2130-2137
- 作者机构：
  
  1.400038 重庆，陆军军医大学(第三军医大学)第一附属医院：急诊医学科
  2.730030 兰州，解放军96604部队医院：医学工程与信息科
  3.400038 重庆，陆军军医大学(第三军医大学)第一附属医院：临床护理学教研室
  4.730030 兰州，解放军96604部队医院：外一科
- 作者简介：
  
  [孙溦, E-mail: sunfamily@tmmu.edu.cnSUN Wei, E-mail: sunfamily@tmmu.edu.cn
- 基金信息：
  
  重庆市自然科学基金面上项目(CSTB2022NSCQ-MSX1400)
- DOI：10.16016/j.2097-0927.202404064
  中图分类号： R181.32;R563.5;R681.54
- 收稿：2024-04-15，
  
  修回：2024-07-05，
  
  纸质出版：2024-09-30
- 稿件说明：
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李伊敬, 鄢苏鹏, 邵艳霞, 等. 急性脊柱损伤患者发生肺栓塞的危险因素分析[J]. 陆军军医大学学报, 2024,46(18):2130-2137.

Yijing LI, Supeng YAN, Yanxia SHAO, et al. Risk factors for pulmonary embolism in patients with acute spinal cord injury[J]. Journal of Army Medical University, 2024, 46(18): 2130-2137.
李伊敬, 鄢苏鹏, 邵艳霞, 等. 急性脊柱损伤患者发生肺栓塞的危险因素分析[J]. 陆军军医大学学报, 2024,46(18):2130-2137. DOI： 10.16016/j.2097-0927.202404064.

Yijing LI, Supeng YAN, Yanxia SHAO, et al. Risk factors for pulmonary embolism in patients with acute spinal cord injury[J]. Journal of Army Medical University, 2024, 46(18): 2130-2137. DOI： 10.16016/j.2097-0927.202404064.

摘要

目的

分析影响急性脊柱损伤患者肺栓塞发生的危险因素。

方法

采用病例-对照研究设计方案。收集2018年1月至2023年8月期间陆军军医大学3所附属医院收治的840例急性脊柱损伤患者的基本信息、损伤原因、损伤部位、影像学及实验室检查等相关资料，按照患者是否并发肺栓塞分为2组：发生肺栓塞患者83例；未发生肺栓塞患者757例。对2组患者性别、年龄、住院时间、ICU时间、损伤原因等37个危险因素指标进行单因素分析，再对筛选出的有意义的变量进行多因素Logistic回归分析。

结果

急性脊柱损伤患者单因素分析提示年龄、住院时间、下肢骨折、肺部挫伤及感染、休克、手术次数等24个危险因素与肺栓塞的发生有关(

0.05)。多因素二元Logistic回归分析提示，年龄(

=0.000，

=1.957，95%

：1.532~2.499)、ICU时间(

=0.000，

=2.561，95%

：1.728~3.794)、手术次数(

=0.015，

=1.814，95%

：1.124~2.927)、脊柱固定(

=0.004，

=0.370，95%

：0.189~0.724)、限制性体位(

=0.000，

=21.269，95%

：5.276~85.740)、血小板(

=0.000，

=1.553，95%

：1.236~1.951)、D-二聚体(

=0.000，

=1.600，95%

：1.376~1.860)、凝血酶原时间(

=0.025，

=2.756，95%

：1.138~6.670)是急性脊柱损伤患者肺栓塞的独立危险因素。

结论

急性脊柱损伤患者肺栓塞组病死率明显高于非肺栓塞组，年龄、ICU时间、手术次数、脊柱固定、限制性体位、血小板、D-二聚体、凝血酶原时间与急性脊柱损伤患者发生肺栓塞密切相关。

Abstract

Objective

To investigate the risk factors for pulmonary embolism (PE) in patients with acute spinal cord injury (ASCI).

Methods

A case-control design was adopted in this study. Basic information

injury cause

injury site

imaging and laboratory examination results and other relevant data of 840 ASCI patients admitted to 3 affiliated hospitals of Army Medical University from January 2018 to August 2023 were collected. According to occurrence of PE or not

these patients were divided a PE group (

=83) and a non-PE group (

=757). Univariate analysis was performed on 37 risk factors including gender

age

length of hospital stay

length of intensive care unit (ICU) stay

cause of injury

and so on

and then multivariate logistic regression analysis was applied to analyze these selected significant variables.

Results

Univariate analysis showed that 24 factors such as age

length of hospital stay

lower limb fracture

pulmonary contusion and infection

shock and number of operations were related to the occurrence of PE in ASCI patients (P

0.05). Binary logistic regression analysis indicated that age (

=0.000

=1.957

95%

: 1.532~2.499)

length of ICU stay (

=0.000

=2.561

95%

: 1.728~3.794)

number of operations (

=0.015

=1.814

95%

: 1.124~2.927)

spinal fixation (

=0.004

=0.370

95%

: 0.189~0.724)

restrictive position (

=0.000

=21.269

95%

: 5.276~85.740)

platelet count (

=0.000

=1.553

95%

: 1.236~1.951)

D-dimer level (

=0.000

=1.600

95%

: 1.376~1.860) and prothrombin time (

=0.025

=2.756

95%

: 1.138~6.670) were independent risk factors for PE in the patients.

Conclusion

The mortality of the ASCI patients with PE is significantly higher than those without. Age

length of ICU stay

number of operations

spinal fixation

restrictive position

platelet count

D-dimer level and prothrombin time are closely associated with PE in ASCI patients.

关键词

Keywords

references

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