静脉血栓栓塞症的临床研究  

Clinical study on venous thromboembolism

作　　者：谢玮[1] 冯莹[1] 陈安薇[2] 刘凌[1] 李翠贞[3] 

机构地区：[1]广州医学院第二附属医院,广东广州510120 [2]广州医学院第三附属医院,广东广州510120 [3]广州市第一人民医院,广东广州510120

出　　处：《中国热带医学》2009年第3期489-491,共3页China Tropical Medicine

基　　金：广东省科技计划项目资助课题(编号:2005B30601008)

摘　　要：目的提高对深静脉血栓形成(DVT)和肺血栓栓塞症(PTE)的致病因素与临床特点的认识,以利于及早诊治。方法对广州地区确诊DVT与PTE住院患者475例的临床资料做一回顾性分析。结果近15年住院患者中DVT与PTE患者的比例呈上升趋势。这些病例有80.4%显示有危险因素,≥2个危险因素者占44.9%。最常见的危险因素为年龄≥40岁(89.5%)、卧床≥3d(51%)、手术(22.9%)、恶性肿瘤(16.6%)、糖尿病(13.5%)、高血压(10.5%)、外伤(10.5%)等。DVT患者最常见临床症状是患肢肿胀(56.0%)和疼痛(48.5%),PTE以胸痛(28.1%)和咯血(16.1%)为主。DVT合并PTE占3.5%。DVT累及部位以左下肢多见,好发于近端静脉。DVT与PTE的辅助诊断检查以无创方法为首选。DVT患者抗凝治疗有效率为90.8%,溶栓治疗为92.9%。DVT死亡率为6.1%,PTE为18.8%。结论认识DVT-PTE的各种危险因素及临床征象,并利用各种辅助检查,可提高诊断的准确性。及早治疗对该病具有重要意义。Objective To have a better understanding of the pathogenic risk factor and clinical feature of deep venous thrombosis （DVT） and pulmonary thremboembolism （PTE）, so as to diagnose and treat these diseases without delay. Methods The clinical data of 475 hospitalized patients with DVT-PTE was retrospectively studied. Results The incidence of hospitalized DVT-PTE patients showed a increasing trend in recent 15 years. 80.4% of the patients had risk factor and 44.9% had at least two risk factors. The most common risk factors were over the age 40 years （89.5%）, prolonged immobilization over 3 days（51%）, surgery（22.9%）, malignancy （16.6%）, diabetes（13.5%）,hypertension（10.5%） and trauma （10.5%）.Tbe most conunon clinical presentations of patients were swelling（56.0%） and pain（48.5%） of the affected extremity. Thoraeodynia （28.1%） and emptysis （16.1%） were the main clinical presentations of PTE. PTE was found in 3.5% of the DVT cases. DVT was seen more common in left extremities and proximal vein. The initial diagnostic modality for DVT-PTE should be non-invasive testing. The effective power of anticoagulant therapy was 90.8%, and thrombolytic therapy was 92.9%. Mortality of DVT was 6.1% and PTE was 18.8%. Conclusion It is essential to identify various risk factors and clinical presentations of DVT and VIE, and to select suitable assistant examinations for the improvement of treatment veracity. It is important to treat DVT and PTE as early as possible.

关 键 词：深静脉血栓形成 肺血栓栓塞症 危险因素 临床特征 回顾性分析 

分 类 号：R543.6[医药卫生—心血管疾病]