静脉血栓栓塞症343例临床分析  

Clinical Analysis of 343 Cases of Venous Thromboembolism

作　　者：谢玮[1] 廖小花[2] 何倩云[2] 张梓贤[2] 冯丽丝[2] 邱瑞华[2] 梁敏仪[2] 陈燕珊[2] 冯莹[1] 吴建军[2] 

机构地区：[1]广州医学院第二附属医院,广州510260 [2]广州医学院

出　　处：《血栓与止血学》2009年第6期249-251,共3页Chinese Journal of Thrombosis and Hemostasis

基　　金：广东省科技计划项目资助课题(编号:2005B30601008)

摘　　要：目的通过分析静脉血栓栓塞(VTE)的临床特征,为提高其诊断准确率与及早干预治疗提供依据。方法对广州三间教学医院15年来确诊的VTE患者的资料进行回顾性临床分析。结果343例(1992～2006)深静脉血栓形成(DVT)患者,发生于左下肢者(67.5%)多于右下肢者(26.1%)。主要致病危险因素,有年龄>40岁(89.2%)、卧床≥3 d(58.7%)、4周内行手术者(20.4%)、恶性肿瘤(16.8%)、糖尿病(12.3%)、曾发生静脉血栓病史者(11.1%),同时存在2个或2个以上危险因素者占40%。临床表现主要为患肢疼痛与压痛(49.4%)、下肢肿胀(69.9%)、患者小腿>健侧≥3 cm(55.8%)。肺栓塞(PTE)主要症状为胸痛(35.3%)、心率>100次/min(47.1%)。彩色多普勒血流显像(CDFI)对DVT和多层螺旋CT对PTE的辅助诊断效果佳。结论警觉DVT-PTE存在的致病危险因素,细致掌握临床表现,及时应用辅助诊断技术,可提高诊断水平并可加强干预治疗。Objective Analyzing the clinical characteristics of venous thromboembolism （VTE） , in order to improve the accurate diagnosis rate as well as to take a prophylaxis and treatment measures without delay. Methods Collecting hospitalized VTE patients including deep venous thrombosis （DVT）and pulmonary thromboembolism （PTE） cases from 3 hospitals by retrospective study in Guangzhou. Results 343 cases with DVT and PTE from 1992 to 2006. The affected site of DVT was more common in left extremities （67.5%） than in right legs （26.1%）. More cases with DVT appeared risk factors, there were age over 40 years old （89.2%）, prolonged immobilization over 3 days （58.7%）, surgery within 4 weeks（22.8%）, malignancy （16.8%） ,diabetes （12.3%） and had a history of DVT or PTE, etc. 40% of the patients might had more than 2 risk factors. The common clinical presentations of DVT were swelling （69.9%） or pain （49.4%） of the affected extremity, especially the affected calf swelled more than 3 cm compared with the asymptomatic leg （35.3%）. Thoracodynia （35.3%） and heart rhythm over 100 per minutes （47.1% ） were the main clinical presentations of PTE. The color doppler flow imaging （CDFI） for DVT and CT for PTE were effective. Conclusion It is essential to identify various risk factors and know well clinical presentations of DVT and PTE, as well as carry out useful assistant examination, it will improve the diagnosis correctly and take prophylaxis or treatment of these diseases effectively.

关 键 词：静脉血栓栓塞 深静脉血栓形成 肺血栓栓塞 

分 类 号：R543.6[医药卫生—心血管疾病]