烟台山医院骨科住院患者静脉血栓栓塞症的临床流行病学调查  

The clinical epidemiology of inpatients in orthopedic department with venous thromboembolism

作　　者：费建文[1] 姜军艳 唐燕[1] 周冬梅[3] 康丽君[1] 

机构地区：[1]烟台市烟台山医院呼吸内科 [2]烟台市烟台山医院病案室 [3]烟台市烟台山医院肿瘤科

出　　处：《中华临床医师杂志（电子版）》2012年第2期57-60,共4页Chinese Journal of Clinicians(Electronic Edition)

基　　金：国家"十五"科技攻关课题资助项目(2001BA703B15);烟台市科技发展计划资助项目(2002114)

摘　　要：目的探讨我院骨科住院患者静脉血栓栓塞症(VTE)的临床流行病学情况。方法调查了2002年6月至2010年12月我院骨科收治的20146例住院患者,对其临床资料进行回顾性分析,并对VTE患者的性别、年龄、吸烟史、伴随疾病等危险因素等进行统计分析。结果 (1)共发现1134例(5.63%)VTE患者,深静脉血栓形成(DVT)患病率5.58%,肺血栓栓塞症(PTE)患病率0.48%,PTE病死率13.40%。(2)DVT发生于下肢1068例(94.9%),下腔静脉34例(3.0%),盆腔静脉15例(1.3%),上肢8例(0.7%)。下肢DVT发生于肌间静脉391例(34.8%);其次为胫静脉273例(24.3%)。左侧589例(55.1%)与右侧568例(53.2%)差异无统计学意义(χ2=0.409,P>0.05)。(3)VTE患者的平均年龄为(57.4±10.5)岁,发病高峰在51～60岁(28.8%)。男女VTE患病率差异无统计学意义(U=0.145,P>0.05)。(4)VTE患者最常见的危险因素有年龄>40岁(1060例,93.5%)、创伤(1035例,91.3%)、手术(943例,83.2%)、卧床≥5d(613例,54.1%)、吸烟≥400支/年并且戒烟<5年者(485例,42.8%)、合并内科疾病(83例,7.3%)。结论 (1)VTE的患病率随年龄的增长而增长;(2)VTE患病率男女性别无差异;(3)DVT好发于下肢,且多发生于肌间静脉,其次为胫静脉;(4)VTE患者最常见的危险因素有创伤、手术、高龄、制动、长期吸烟、心肺疾患、恶性肿瘤、VTE既往史等。Objective To investigate the clinical epidemiological characteristics of venous thromboembolism （VTE）. Methods The clinical data of 20 146 inpatients were reviewed. Results （1） 1134 cases of VTE constituted 5. 63% of the inpatients. The incidence of DVT and PTE were respectively 5.58% and 0.48%. （2） Of all the DVT patients, there were lower limb DVT 1068 cases （94. 9 %）, inferior vena cava 34 cases （3.0%）, cavitas pelvis veins 15 cases（1.3%）, and upper extremity veins 8 cases（0.7%）. Of all the lower limb DVT patients, there were vein thrombosis among muscles 391 eases（34. 8%） ,tibial veins 273 cases（24. 3%）. There were no significant differences in patients with lower limb DVT between left and right （ X^2 = 0. 409, P 〉 0.05）. （3） The average age of patient with VTE was between （57.4±10. 5）years old, and the peak age of morbidity were between 51-60 years old. There were no significant differences in patients with VTE between males and females （U = 0. 145, P 〉 0. 05）. （4） The high risk factors included age more than 40 years 1060 cases （93.5%）, trauma 1035 cases （91.3%）, surgery 943 cases（83.2%） ,lying in bed more than 5 days 613 cases（54. 1%） ,long-term smoking 485 cases（42. 8%）, etc. Conclusions （1）The incidence of VTE were increasing with the age. （2）The incidence of VTE had no significant difference between males and females. （3） DVT mainly occurred in lower limb, especially vein thrombosis among muscles and tibial veins. （4） The most common risk factors were trauma, surgery, age over 40 years old, braking, long-term smoking, cancer, cardiac and pulmonary disease, history of VTE, etc.

关 键 词：静脉血栓栓塞 流行病学 医院 骨科 

分 类 号：R543.6[医药卫生—心血管疾病] R181.3[医药卫生—内科学]