Abstract: Objective To investigate the risk factors of perioperative isolated deep vein thrombosis of the distal lower extremities in patients with acute stroke. Methods A retrospective analysis of the case data of acute stroke patients admitted to the First Affiliated Hospital of University of Science and Technology of China from September 2019 to May 2020,the patients were grouped according to the results of the dynamic ultrasound examination of the whole lower extremity veins,and multivariate logistics regression was applied.Analyze and determine the patient's age,gender,body mass index,admission GCS score,APACHE Ⅱ score,NICU stay time,whether there is brain hernia and shock,operation time,gastrointestinal hemorrhage,acute kidney injury,acute liver injury,blood transfusion and other factors and isolation The relationship between the occurrence of deep vein thrombosis in the distal lower limbs. Results A total of 105 patients with acute stroke were included,of which 83 were hemorrhagic stroke and 22 were ischemic stroke;71(68%) patients had isolated deep vein thrombosis of the distal lower extremities,and 57 cases(80%) were asymptomatic,12 cases(17%) developed thrombosis progression;univariate analysis showed that the patient's age(P=0.02),body mass index(P=0.009),admission GCS score(P=0.004),and red blood cell transfusion(P=0.035) were acute The risk factors of perioperative isolated deep vein thrombosis of the lower extremities in stroke patients.Multivariate logistic regression analysis showed that the patient's age was >60 years old(P=0.036,95%CI=1.068～7.458),and the admission GCS score was >8 Score(P=0.005,95%CI=0.087～0.641) and red blood cell transfusion(P=0.049,95%CI=0.44～0.932) are independent risk factors for the occurrence of deep vein thrombosis in the distal lower limbs. Conclusion The incidence and progression rate of isolated distal deep vein thrombosis in patients with acute stroke during the perioperative period are relatively high.Patient age,GCS score and blood transfusion are independent risk factors for thrombosis.For this type of patients,deep vein thrombosis of lower extremity should be strengthened,screening work.

Key words: Acute stroke, Isolated distal deep vein thrombosis, Risk factors

摘要： 目的 探讨急性脑卒中患者围手术期孤立性下肢远端深静脉血栓发生的危险因素。方法 回顾性分析中国科技大学附属第一医院神经重症2019年9月至2020年5月收治的急性脑卒中患者的病例资料,根据全下肢静脉超声动态检查结果将患者进行分组,应用多因素logistics回归分析判断患者年龄、性别、体重指数、入院GCS评分、APACHEⅡ评分、NICU入住时间、是否存在脑疝及休克、手术时间、消化道出血、急性肾损伤、急性肝损伤、输血量等因素与孤立性下肢远端深静脉血栓发生的关系。结果 共纳入105例急性脑卒中患者,其中出血性卒中83例,缺血性卒中22例;71例(68%)患者存在孤立性下肢远端深静脉血栓,无症状者57例(80%),12例(17%)出现血栓进展;单因素分析结果显示患者年龄(P=0.02)、体重指数(P=0.009)、入院GCS评分(P=0.004)、红细胞输入(P=0.035)是急性脑卒中患者围手术期发生孤立性下肢远端深静脉血栓的危险因素,多因素logistics回归分析结果提示患者年龄>60岁(P=0.036,95%CI=1.068～7.458)、入院GCS评分>8分(P=0.005,95%CI=0.087～0.641)、红细胞输入(P=0.049,95%CI=0.44～0.932)是下肢远端深静脉血栓发生的独立危险因素。结论 急性脑卒中围手术期患者孤立性下肢远端深静脉血栓发生率和进展率均较高,患者年龄、GCS评分及输血是血栓形成的独立危险因素,针对该类患者应加强下肢深静脉血栓的筛查工作。

关键词: 急性脑卒中, 孤立性下肢远端深静脉血栓, 危险因素