创伤性胸腰椎骨折患者术后血栓分布及孤立性远端血栓的临床特点OA

Objective To analyze the postoperative thrombus distribution and clinical characteristics of isolated distal thrombosis in patients with traumatic thoracolumbar fractures.Methods A retrospective analysis was conducted on 719 patients with thoracolumbar fractures caused by high-energy injuries who underwent surgical treatment from October 2018 to October 2024.The cohort included 506 males and 213 females,aged from 19 to 69 years with a mean age of(44.82±11.61)years.Postoperative deep venous color Doppler ultrasound of both lower limbs was performed,revealing thrombosis in 149 patients.Based on postoperative thrombus distribution,patients were divided into an isolated distal thrombosis group and a proximal thrombosis group.Clinical data,laboratory indicators,and ultrasound parameters were compared between the two groups.Uni-variate factors with P＜0.05 were further analyzed using binary Logistic regression for multivariate analysis.Results Isolated distal deep vein thrombosis(DVT)occurred in 12.4％(89/719)of patients,accounting for 59.7％(89/149)of all DVT cases.Thromboses were located in the posterior tibial vein in 17 cases(19％),peroneal vein in 13 cases(15％),and intermuscular veins in 59 cases(66％).Univariate analysis showed statistically significant differences between the isolated distal thrombosis group and the proximal thrombosis group in leg pain(P=0.016),leg swelling(P=0.0 13),affected limb circumference differ-ence(P＜0.001),D-dimer(P＜0.001),blood flow velocity(P＜0.001),and peak flow velocity(P＜0.001).Logistic regression analysis indicated that,compared with the proximal thrombosis group,the isolated distal thrombosis group had a smaller affect-ed limb circumference difference[OR=0.151,95％CI(0.066,0.347),P＜0.001]and lower D-dimer levels[OR=0.734,95％CI(0.580,0.930),P=0.010],while mean blood flow velocity[OR=1.144,95％CI(1.047,1.249),P=0.003]and peak flow velocity[OR=1.379,95％CI(1.169,1.626),P＜0.001]were higher.Conclusion Isolated distal DVT accounts for a relatively high pro-portion of cases in patients with traumatic thoracolumbar fractures,with intermuscular veins being the most commonly involved.Compared with proximal thrombosis,isolated distal thrombosis is associated with a smaller affected limb circumference differ-ence,lower D dimer levels,and relatively faster blood flow velocity.