【摘要】：目的探討脊髓損傷(spinal cord injury,SCI)且應(yīng)用血液循環(huán)泵治療的患者下肢血栓的發(fā)生現(xiàn)狀及影響因素,為臨床有效的防治脊髓損傷患者下肢血栓提供依據(jù)。方法本研究采用病例對(duì)照研究方法。選取2015年9月至2016年8月期間在唐山市第二醫(yī)院住院的所有脊髓損傷并接受血液循環(huán)泵治療的患者422例為對(duì)象,在患者入院3天內(nèi)完成基線(xiàn)調(diào)查,調(diào)查患者的一般人口學(xué)資料,并完成下肢靜脈血栓認(rèn)知調(diào)查問(wèn)卷和下肢靜脈血栓健康信念調(diào)查問(wèn)卷;在患者出院時(shí)通過(guò)查閱病例調(diào)查患者的治療及手術(shù)情況、臨床癥狀等情況,并調(diào)查患者在經(jīng)血液循環(huán)泵治療期間發(fā)生下肢靜脈血栓的情況并記錄發(fā)生時(shí)間,以發(fā)生下肢血栓的脊髓損傷患者作為病例組,未發(fā)生下肢血栓的脊髓損傷患者作為對(duì)照組,統(tǒng)計(jì)分析經(jīng)血液循環(huán)泵治療的脊髓損傷患者發(fā)生下肢血栓的影響因素。數(shù)據(jù)采用SPSS17.0統(tǒng)計(jì)軟件進(jìn)行分析,采用單因素、多因素logistic回歸模型分析。結(jié)果1本次調(diào)查的422例脊髓損傷患者中,發(fā)生下肢血栓的患者共68例,發(fā)生率16.1%。2脊髓損傷患者下肢血栓發(fā)生的影響因素單因素分析結(jié)果:病例組與對(duì)照組患者在婚姻、文化程度、睡眠、損傷程度、排尿情況、脈搏、低分子肝素的注射、血液循環(huán)泵的使用、輸血史、DVT的認(rèn)知及健康信念水平等方面差異有統(tǒng)計(jì)學(xué)意義(P0.05)。3脊髓損傷患者下肢靜脈血栓發(fā)生的影響因素logistic多因素回歸分析結(jié)果:患者的損傷程度(OR=2.105,P0.05)、排尿(OR=3.313,P0.05)、文化程度(OR=0.560,P0.05)、低分子肝素的注射(OR=0.290,P0.05)、血液循環(huán)泵的使用(OR=0.499,P0.05)、下肢靜脈血栓的認(rèn)知水平(OR=0.911,P0.05)是血液循環(huán)泵治療的脊髓損傷患者下肢靜脈血栓發(fā)生的影響因素。結(jié)論1接受血液循環(huán)泵治療的住院脊髓損傷患者下肢血栓的發(fā)生率16.1%。2患者的損傷程度、排尿情況、文化程度、低分子肝素的注射、血液循環(huán)泵的使用、下肢靜脈血栓的認(rèn)知水平是血液循環(huán)泵治療的脊髓損傷患者下肢靜脈血栓發(fā)生的影響因素。
[Abstract]:Objective to investigate the status quo and influencing factors of lower extremity thrombosis in patients with spinal cord injury (spinal cord injury,SCI) treated with blood circulation pump, and to provide evidence for clinical prevention and treatment of lower extremity thrombosis in patients with spinal cord injury. Methods A case-control study was conducted. From September 2015 to August 2016, 422 patients with spinal cord injury who were hospitalized in the second Hospital of Tangshan City and received blood circulation pump therapy were selected as subjects. The baseline survey was completed within 3 days after admission, and the general demographic data of the patients were investigated. And completed the lower extremity venous thrombosis cognition questionnaire and the lower extremity venous thrombosis health belief questionnaire; At the time of discharge from hospital, the patients were investigated for treatment and operation, clinical symptoms and so on. The patients' venous thrombosis of lower extremity was investigated during the treatment of blood circulation pump and the time of occurrence was recorded. Patients with spinal cord injury (sci) with lower extremity thrombus as case group and patients with spinal cord injury (sci) without lower extremity thrombus as control group were used as control group. The influencing factors of lower extremity thrombosis in patients with spinal cord injury treated by blood circulation pump were analyzed statistically. The data were analyzed by SPSS17.0 statistical software, single factor and multi-factor logistic regression model. Results (1) of 422 patients with spinal cord injury, 68 had lower extremity thrombosis. The incidence of lower extremity thrombosis in patients with spinal cord injury was analyzed by univariate analysis. Results: marriage, education, sleep, injury, urination, pulse, injection of low molecular weight heparin (LMWH) were observed in the case group and the control group. Use of blood circulation pumps, history of blood transfusions, There were significant differences in the cognitive and health belief levels of DVT (P0.05). 3 logistic multivariate regression analysis showed that the degree of injury (OR=2.105,P0.05) in patients with spinal cord injury was related to the occurrence of venous thrombosis in lower extremity. Urination (OR=3.313,P0.05), education level (OR=0.560,P0.05), low molecular weight heparin injection (OR=0.290,P0.05), blood circulation pump use (OR=0.499,P0.05), The cognitive level (OR=0.911,P0.05) of venous thrombosis of lower extremity is the influencing factor of venous thrombosis of lower extremity in patients with spinal cord injury treated by blood circulation pump. Conclusion 1 the incidence of lower extremity thrombosis in patients with spinal cord injury treated by blood circulation pump is 16.1.2 the degree of injury, urination, education, injection of low molecular weight heparin, use of blood circulation pump. The cognitive level of venous thrombosis of lower extremity is the influencing factor of venous thrombosis in patients with spinal cord injury treated by blood circulation pump.
【學(xué)位授予單位】：華北理工大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R473.6

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