Analysis Of The Relationship Between Deep Vein Thrombosis And Diabetes In Patients With Cholelithiasis After Laparoscopic Surgery

Objective:Retrospective analysis of Deep Vein Thrombosis(DVT)and the relationship between Diabetes Mellitus(DM)and laparoscopic surgery in patients with cholelithiasis.To investigate the risk factors of deep vein thrombosis of lower extremity after laparoscopic surgery.Methods:From January 2018 to January 2023,a total of 118 inpatients in the surgical ward of the Affiliated Hospital of Inner Mongolia Medical University were retrospectively studied.The selected patients were divided into diabetic group and non-diabetic group according to whether they had diabetes mellitus(Fasting Plasma Glucose(FPG)≥7.0mol/L)after laparoscopic cholecystectomy.The incidence of postoperative deep vein thrombosis was compared between the two groups with diabetes mellitus or not.According to the occurrence of postoperative deep vein thrombosis,the patients were divided into the occurrence group and the non-occurrence group,and the influencing factors of deep vein thrombosis were deeply analyzed.Patient data were consulted,gender,age,height,weight and Body Mass Index(BMI)were calculated;Coagulation function and post-operative Platelet(PLT)count;Fasting blood glucose,whether diabetes is treated and how to treat it;Perioperative indicators,postoperative subcutaneous injection of Low Molecular Weight Heparin(LMWH),occurrence of lower extremity deep vein thrombosis,treatment methods and post-treatment conditions,etc.,univariate and multivariate Logistic regression analysis were performed for all the above possible factors.Results:(1)Among 118 patients with cholelithiasis,25 were diabetic,accounting for 21.19%.Deep vein thrombosis occurred in 7 of 25 patients in the diabetes group(28.00%),which was higher than that in the non-diabetes group(8.60%,8 of 93 patients)(P<0.05).There was no significant difference in the occurrence site between diabetic group and non-diabetic group(P>0.05).The rate of complete vascular blockage in diabetic group(57.14%)was higher than that in non-diabetic group(37.50%),but there was no statistical difference(P> 0.05).(2)Deep vein thrombosis occurred in 15 of 118 patients with cholelithiasis after laparoscopic cholecystectomy,with an incidence of 12.71%.The results of single factor analysis show that: The incidence of deep vein thrombosis in patients with chololithiasis after laparoscopic surgery was related to diabetes,diabetes treatment,postoperative injection of low molecular weight heparin,postoperative platelet count,postoperative bed time,D-Dimer(D-D)and fibrinogen(Fib)level.There was statistical significance(P< 0.05).(3)The results of multi-factor analysis show that: Diabetes mellitus(β=1.682,OR=1.283,95%CI =1.095-2.706),whether to treat diabetes mellitus(β=1.602,OR=4.965,95%CI=1.207-20.412),whether to inject low molecular weight heparin(β=1.936,OR=6.933,95%CI=2.419-19.874),postoperative platelet count(β=0.011,OR=1.012,95% CI=1.001-1.022),postoperative bed time(β=0.144,OR=1.155,95% CI=1.037-1.286),D-dimer quantity(β=0.677,OR=1.969,95% CI=1.059-3.661),Fib level(β=1.850,OR=6.358,95%CI=2.218-18.224)were independent risk factors for deep vein thrombosis in patients with cholelithiasis after laparoscopic surgery(P< 0.05).Conclusions:(1)Laparoscopic deep vein thrombosis in cholelithiasis patients is closely related to diabetes,and the incidence of postoperative deep vein thrombosis in diabetic patients is higher than that in non-diabetic patients.(2)There are many factors affecting the formation of deep vein thrombosis in patients with cholelithiasis after endoscopic surgery.For the possible influencing factors,corresponding preventive and therapeutic measures should be taken to strictly control the blood sugar of patients,and at the same time,dietary habits and anti-platelet therapy should be changed to improve circulation of lower limbs and reduce the occurrence of postoperative deep vein thrombosis.