中国组织工程研究

中国组织工程研究 ›› 2026, Vol. 30 ›› Issue (27): 7130-7134.doi: 10.12307/2026.840

• 脊柱植入物Spinal implants • 上一篇    下一篇

术前贫血与择期腰椎融合后患者下肢深静脉血栓形成的相关性

张浩亮，王之兵，单  涛，韩国嵩，李  春   

  1. 安徽医科大学第三附属医院，安徽省合肥市  230071
  • 收稿日期:2025-09-17 接受日期:2026-01-05 出版日期:2026-09-28 发布日期:2026-05-15
  • 通讯作者: 李春，主任医师，安徽医科大学第三附属医院脊柱外科，安徽省合肥市 230071
  • 作者简介:张浩亮，男，1997年生，安徽省亳州市人，汉族，2024年徐州医科大学毕业，硕士，主要从事脊柱外科方面的研究。
  • 基金资助:
    安徽医科大学第三附属医院基础与临床合作研究项目(2023sfy015)，项目负责人：韩国嵩

Correlation between preoperative anemia and lower extremity deep vein thrombosis in patients after elective lumbar fusion

Zhang Haoliang, Wang Zhibing, Shan Tao, Han Guosong, Li Chun   

  1. Third Affiliated Hospital of Anhui Medical University, Hefei 230071, Anhui Province, China
  • Received:2025-09-17 Accepted:2026-01-05 Online:2026-09-28 Published:2026-05-15
  • Contact: Li Chun, Chief physician, Third Affiliated Hospital of Anhui Medical University, Hefei 230071, Anhui Province, China
  • About author:Zhang Haoliang, MS, Third Affiliated Hospital of Anhui Medical University, Hefei 230071, Anhui Province, China
  • Supported by:
    Basic and Clinical Collaborative Research Project of Third Affiliated Hospital of Anhui Medical University, No. 2023sfy015 (to HGS) 

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摘要：

文题释义：

腰椎融合：是一种消除相邻腰椎间异常活动、恢复脊柱稳定性的骨科手术，核心目标是实现椎体间骨性融合，通常适用于退行性椎间盘疾病伴顽固性腰痛、腰椎滑脱、椎管狭窄或椎间盘切除术后复发等病理状态。
深静脉血栓形成：是血液在深静脉腔内异常凝结的病理状态，核心风险为高凝、瘀滞与内皮损伤三要素，骨科手术后未抗凝者深静脉血栓发生率能高达40%-60%；诊断依赖超声(敏感性> 95%)及D-二聚体> 500 μg/L，漏诊可致肺栓塞(占静脉血栓栓塞症的50%-67%)，并且仍有20%-50%的患者发展为血栓后综合征。

摘要
背景：下肢深静脉血栓形成是腰椎融合术后灾难性并发症，既往研究显示一些诸如人工关节置换、腹部手术等患者合并术前贫血，易导致术后下肢深静脉血栓形成。但术前贫血是否会增加腰椎融合术后下肢深静脉血栓形成的风险，目前尚不明确。
目的：探讨术前贫血与腰椎融合术后患者下肢深静脉血栓形成之间的相关性。
方法：回顾性分析了2020年1月至2023年12月安徽医科大学第三附属医院收治的1 178例接受腰椎融合治疗患者的临床资料。根据患者术后是否发生下肢深静脉血栓形成，将患者分为深静脉血栓组(彩超报告提示下肢深静脉血栓形成)和非深静脉血栓组(彩超报告提示无下肢深静脉血栓形成表现)。比较两组患者贫血发生率，并通过单因素分析和多因素Logistic回归分析确定腰椎融合患者下肢深静脉血栓形成的危险因素。
结果与结论：①1 178例患者中，深静脉血栓组43例(3.7%)，非深静脉血栓组1 135例(96.4%)；②深静脉血栓组术前贫血发病率为32.6%，显著高于非深静脉血栓组10.9%(P < 0.05)；③单因素分析结果显示，两组患者的术前血红蛋白(P < 0.001)、术前红细胞(P=0.028)、D-二聚体阳性(P=0.029)、高血压(P=0.019)、融合节段数(P=0.023)、贫血(P < 0.001)以及输血情况(P=0.006)等指标存在显著性差异(P < 0.05)；④多因素分析结果显示，术前贫血(OR=4.221，95%CI：1.198-14.802，P=0.025)和D-二聚体阳性(OR=2.023，95%CI：1.065-3.844，P=0.031)是腰椎融合术后发生下肢深静脉血栓的危险因素；⑤提示择期腰椎融合患者术前贫血发生率较高，且术前贫血是腰椎融合术后深静脉血栓的独立危险因素；建议在进行择期腰椎融合术前应积极管理和纠正术前贫血状况，以降低下肢深静脉血栓发生风险。



中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

关键词: 腰椎融合, 贫血, 下肢深静脉血栓形成, 腰椎间盘突出症, 单因素分析

Abstract: BACKGROUND: Lower extremity deep vein thrombosis is a catastrophic complication after lumbar spine fusion, and previous studies have shown that some patients, such as those with prosthetic arthroplasty and abdominal surgeries, suffer from a combination of preoperative anemia, which predisposes them to postoperative deep vein thrombosis of the lower extremities. However, whether preoperative anemia increases the risk of lower extremity deep vein thrombosis after lumbar spine fusion is unclear.
OBJECTIVE: To investigate the correlation between preoperative anemia and deep vein thrombosis of the lower extremities in patients after lumbar fusion.
METHODS: The clinical data of 1 178 patients who underwent lumbar spinal fusion treatment admitted to Third Affiliated Hospital of Anhui Medical University from January 2020 to December 2023 were retrospectively analyzed. According to whether or not the patients developed lower extremity deep vein thrombosis after the operation, and the patients were divided into the deep vein thrombosis group (ultrasound report suggestive of lower extremity deep vein thrombosis) and the non-deep vein thrombosis group (ultrasound report suggestive of no lower extremity deep vein thrombosis manifestation). The incidence of anemia was compared between the two groups. The risk factors for lower extremity deep vein thrombosis in patients undergoing lumbar spinal fusion were determined by univariate analysis and multifactorial logistic regression analysis.
RESULTS AND CONCLUSION: (1) Of the 1 178 patients, 43 (3.7%) were in the deep vein thrombosis group and 1 135 (96.4%) in the non-deep vein thrombosis group. (2) The prevalence of preoperative anemia in the deep vein thrombosis group was 32.6%, which was significantly higher than that in the non-deep vein thrombosis group, which was 10.9% (P < 0.05). (3) The results of univariate analysis showed significant differences in preoperative hemoglobin (P < 0.001), preoperative erythrocytes (P=0.028), D-dimer positivity (P=0.029), hypertension (P=0.019), the number of fused segments (P=0.023), anemia (P < 0.001), and transfusion (P=0.006) (P < 0.05). (4) Multifactorial analysis showed that preoperative anemia (OR=4.221, 95%CI:1.198-14.802, P=0.025) and D-dimer positivity (OR=2.023, 95%CI:1.065-3.844, P=0.031) were independent risk factors for the development of deep vein thrombosis after lumbar fusion. (5) It is indicated that patients undergoing elective lumbar fusion have a high incidence of preoperative anemia, and preoperative anemia is an independent risk factor for deep vein thrombosis after lumbar fusion. It is recommended that preoperative anemia should be actively managed and corrected before performing elective lumbar fusion to reduce the risk of deep vein thrombosis.

Key words: lumbar fusion, anemia, deep vein thrombosis of the lower extremities, lumbar disc herniation, univariate analysis

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