上肢创伤骨折并发深静脉血栓18例临床特征分析  

Analysis on the clinical characters of upper limb trauma fracture complicated with deep vein thrombosis in eighteen patients

作　　者：韦溦[1] 杨星华[1] 官正华[1] 刘洋[1] 田华科[1] 陈辉[1] 郭元[1] 

机构地区：[1]解放军324医院创伤显微外科,重庆400020

出　　处：《检验医学与临床》2014年第5期605-606,共2页Laboratory Medicine and Clinic

摘　　要：目的探讨上肢创伤骨折并发深静脉血栓(DVT)的临床特征,为其防治提供参考。方法在2008年1月至2012年12月解放军324医院住院病案资料库中检索上肢创伤骨折共2 368例。其中并发上肢DVT患者18例,对18例上肢创伤合并DVT患者的临床特征、诊断及治疗情况进行回顾性分析。结果上肢创伤骨折合并DVT患者主要临床表现:患肢疼痛、单侧患肢肿胀、皮温升高、患肢皮肤呈紫红色。18例患者中血清D-二聚体水平增高16例,经上肢血管彩色多普勒超声检查发现血栓位于肱静脉9例,腋静脉3例,腋静脉至肱静脉4例,锁骨下静脉至肱静脉2例。该类患者多合并糖尿病、高血脂等基础疾病,且多为肱骨以上骨折、粉碎性骨折、多处骨折。18例患者中经溶栓治疗16例,14例溶栓成功。结论了解上肢创伤骨折并发DVT患者的临床特征,对其防治具有重要的指导意义,对该类患者应及时发现,进行早期溶栓治疗。Objective To explore the clinical characters of upper limb trauma fracture complicated with deep vein thrombosis（DVT ） and provide references for the prevention and treatment .Methods The clinical characters ,di-agnosis ,and treatment of 18 patients with upper limb trauma fractures complicated with DVT were analyzed retro-spectively .Results The clinical manifestation was pain ,swelling ,skin temperature elevated ,and prunosus skin .There were 16 patients with increased levels of D-dimer .There were 9 patients with thrombosis located in brachial vein ,3 patients in axillary vein ,4 patients in axillary vein to brachial vein ,and 2 in subclavian vein to brachial vein deter-mined by color Doppler ultrasonography .Most of these patients were complicated with underlying diseases such as di-abetes ,hyperlipemia ,etc .Most of them were fractures above of humerus ,thrypsis and multiple fractures .Sixteen pa-tients were treated by thrombolysis and 14 patients were succeeded .Conclusion It is an instruction for the preven-tion and treatment of upper limb trauma fracture complicated with DVT to get their clinical characters .The patients should be discovered in time and arranged throbothysis in early time .

关 键 词：上肢创伤骨折 深静脉血栓 临床特征 

分 类 号：R543.6[医药卫生—心血管疾病]