Analysis of risk assessment and prevention of lower limb deep venous thrombosis in intensive care unit patients

Li Yinhua; Li Dengkai; Liu Lei

doi:10.3760/j.issn.1673-4777.2024.06.015

Abstract：Objective To explore the implementation of risk assessment and prevention effect of lower limb deep venous thrombosis(DVT)in intensive care unit(ICU)patients.Methods The clinical data of 148 patients admitted to the ICU of Aviation General Hospital from July 1,2022 to June 30,2023 were collected and retrospectively analyzed.According to whether DVT occurred within 24 h of ICU admission,the patients were divided into DVT group(45 cases)and non-DVT group(103 cases).The patients in the non-DVT group were further divided into new-onset DVT group(16 cases)and non-new-onset DVT group(87 cases)according to the evaluation results within 2 weeks of ICU admission(after 24 h).The evaluation of DVT in ICU patients was summarized through DVT risk score,D-dimer,and fibrinogen levels,and the effectiveness of relevant preventive measures for DVT was observed.Results Acute physiology and chronic health status scoring system 11 score in DVT group was higher than that in non-DVT group(P＜0.05).There was no significant difference in DVT risk score between medical and surgical patients in DVT group,non-DVT group,non-new-onset DVT group and new-onset DVT group(all P＞0.05).The levels of D-dimer and fibrinogen in the DVT group were significantly higher than those in the non-DVT group[(10.7±3.4)mg/L vs(3.8±1.7)mg/L,(486±133)g/L vs(376±133)g/L](both P＜0.05).In the non-DVT group,the rates of hospital-acquired DVT were 70.0％(7/10),8.9％(4/45),14.3％(2/14),and 8.8％(3/34)for basic prophylaxis,mechanical prophylaxis,pharmacological prophylaxis alone and mechanical and pharmacological prophylaxis,respectively.The incidences of DVT in patients with mechanical prevention,simple drug prevention and mechanical prevention combined with drug prevention were significantly lower than those in patients with simple basic prevention.The incidence of DVT in patients with mechanical prevention and mechanical prevention combined with drug prevention is lower than that in patients with drug prevention alone(all P＜0.05).Conclusions The incidence of lower limb DVT in ICU patients is high.D-dimer,fibrinogen level and DVT risk score can be used to assess the risk of DVT in patients and guide the corresponding preventive measures.The occurrence of DVT can be effectively avoided by using positive preventive measures for ICU patients.