脑卒中康复期患者下肢深静脉血栓的发生情况及影响因素的研究OA
Research on the occurrence status and contributing factors of deep venous thrombosis in lower limbs among stroke survivors in the rehabilitation phase
目的 探讨脑卒中康复期患者下肢深静脉血栓(deep vein thrombosis,DVT)发生情况并分析影响因素.方法 选取2024年1月至2025年10月浙江省人民医院收治的181例脑卒中患者作为研究对象.根据是否发生DVT分为非DVT组(n=141)与DVT组(n=40).采用单因素和多因素Logistic回归分析,并采用受试者操作特征曲线(receiver operating characteristic curve,ROC曲线)分析脑卒中康复患者下肢深静脉血栓发生的影响因素.结果 181例患者中检出DVT 40例,检出率为22.1%.单因素分析结果显示,性别、年龄、住院时间、卧床时间≥72h、意识障碍、既往静脉血栓栓塞(venous thrombus embolism,VTE)病史、气管插管史、激素治疗、深静脉置管史、Barthel指数(barthel index,BI)评分、Padua量表评分、D-二聚体、下肢Brunnstrom分期是影响脑卒中康复期患者下肢DVT发生的因素.多因素Logsitic回归分析结果显示,年龄、卧床≥72h、深静脉置管史及既往VTE病史是脑卒中康复期患者发生下肢DVT的独立影响因素(OR值分别为1.055、5.089、3.939、13.615,P<0.05).以上述4个自变量构建风险预测模型,模型ROC曲线下面积为0.848,约登指数最大值为0.594,诊断值0.244,敏感度80%,特异性79%.结论 脑卒中康复期患者下肢DVT发生率较高,年龄、卧床≥72h、深静脉置管史及既往VTE病史的脑卒中康复期患者发生下肢DVT的风险更高,应加强相关风险因素的管理,以期有效降低脑卒中康复期患者下肢DVT的发生.
Objective To explore the occurrence of deep vein thrombosis(DVT)in patients during the rehabilitation period of stroke and the risk factors.Methods A total of 181 patients diagnosed with stroke and admitted to Zhejiang Provincial People's Hospital from January 2024 to October 2025 were selected as subjects,they were devided into non-DVT group(n=141)and DVT group(n=40)according to whether DVT.Univariate and multivariate Logistic regression analysis were used to establish a risk prediction model,and the receiver operating characteristic(ROC)curve was used to analyze the influence factors of DVT occurrence in stroke rehabilitation patients.Results Among the 181 patients,40 cases were detected with DVT,with a detection rate of 22.1%.The results of univariate analysis showed that gender,age,length of stay in the rehabilitation department,bed rest time≥72 hours,consciousness disorder,previous history of venous thromboembolism(VTE),history of tracheal intubation,hormone treatment,history of deep vein catheterization,Barthel index(BI)score,Padua scale score,D-dimer,and lower limb Brunnstrom stage were risk factors for DVT occurrence in stroke rehabilitation patients.The results of multivariate Logistic regression analysis showed that age,bed rest time≥72 hours,history of deep vein catheterization and VTE,and the presence of thrombosis history were independent risk factors for DVT occurrence in stroke rehabilitation patients(OR values were 1.055,5.089,3.939,13.615,respectively,P<0.05).The risk prediction model constructed with the above four independent variables had an area under the ROC curve of 0.848,the maximum Youden index was 0.594,the diagnostic value was 0.244,the sensitivity was 80%,and the specificity was 79%.Conclusion The incidence of lower limb DVT in stroke rehabilitation patients is relatively high.The older the age,bed rest time≥72 hours,the history of deep vein catheterization and previous history of VTE in stroke rehabilitation patients have the higher the risk of lower limb DVT.It is necessary to strengthen the management of related risk factors in order to effectively reduce the occurrence of lower limb DVT in stroke rehabilitation patients.
肖伽;陈珊珊;何旭颖
浙江省人民医院脑部损伤康复病区,浙江 杭州 310024浙江省人民医院脑部损伤康复病区,浙江 杭州 310024浙江省人民医院脑部损伤康复病区,浙江 杭州 310024
医药卫生
脑卒中康复下肢深静脉血栓形成影响因素
StrokeRehabilitationDeep vein thrombosis of lower extremitiesInfluencing factors
《中国现代医生》 2026 (20)
1-4,21,5
浙江省医药卫生科技计划项目(2024KY721)
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