产褥期发生深静脉血栓高危因素的研究

Study on High Risk Factors of Deep Venous Thrombosis in Puerperium

摘要: 目的：通过分析我院2020年1月至2021年1月产褥期妇女发生深静脉血栓情况、影响因素及疾病转归，为产褥期深静脉血栓的防治提供依据，对该疾病做到早发现、早诊断、早治疗，从而改善孕产妇预后。方法：收集2020年1月至2021年1月于我院住院分娩的100名孕产妇的临床资料根据人口特征、临床特征等分成实验组(发生产褥期深静脉血栓)、对照组(未发生产褥期深静脉血栓)，应用t检验及X2检验对产褥期深静脉血栓的发生情况及疾病转归进行分析。通过比较两组患者产后D二聚体值及较产前上升幅度进一步验证产褥期静脉血栓发生的高危因素。结果：BMI ≥ 35 (OR值4.16)，高血压(OR值2.04)，可能为深静脉血栓发生的潜在危险因素。BMI ≥ 30、IVF-ET术后、吸烟、孕激素治疗史、甲减、甲亢与产后深静脉血栓的相关性无统计学意义(P > 0.05)。实验组产后D二聚体较产前上升的幅度比对照组高，具有统计学意义(P < 0.05)。结论：产前产后D二聚体差值增大是产褥期静脉血栓发生的危险因素，因此可作为产褥期静脉血栓的预测指标。

Abstract: Objective: To analyze the occurrence, influencing factors and disease outcome of deep venous thrombosis in puerperal women in our hospital from January 2020 to January 2021, so as to provide basis for the prevention and treatment of puerperal deep venous thrombosis, and achieve early detection, early diagnosis and early treatment of the disease, so as to improve the prognosis of pregnant women. Methods: The clinical data of 100 pregnant women who were hospitalized and delivered in our hospital from January 2020 to January 2021 were collected. According to the demographic and clinical characteristics, they were divided into experimental group (with puerperal deep venous thrombosis) and control group (without puerperal deep venous thrombosis). The occurrence and disease outcome of puerperal deep venous thrombosis were analyzed by t-test and X2 test. The high-risk factors of puerperal venous thrombosis were further verified by comparing the postpartum D-dimer value and its increase compared with that before delivery between the two groups. Results: 1 BMI ≥ 35 (or 4.16) and hypertension (or 2.04) may be potential risk factors for deep venous thrombosis. There was no significant correlation between BMI ≥ 30, post IVF-ET, smoking, progesterone treatment history, hypothyroidism, hyperthyroidism and postpartum deep venous thrombosis (P > 0.05). The increase of postpartum D-dimer in the experimental group was higher than that in the control group (P < 0.05). Conclusion: The increase of D-dimer difference between prenatal and postpartum is a risk factor for puerperal venous thrombosis, so it can be used as a predictor of puerperal venous thrombosis.