青年期下肢深静脉血栓形成的原因分析及处理对策  

Analysis of etiology and treatment of adolescent lower extremity deep vein thrombosis

作　　者：魏小龙[1] 吴雅妮[1] 梅志军[1] 冯睿[1] 包俊敏[1] 赵志青[1] 陆清声[1] 周建[1] 景在平[1] 

机构地区：[1]上海第二军医大学附属长海医院血管外科,上海200433

出　　处：《外科理论与实践》2016年第2期134-137,共4页Journal of Surgery Concepts & Practice

摘　　要：目的:探讨青年期(≤35岁)下肢深静脉血栓形成的危险因素及治疗措施。方法 :回顾性分析我科自2010年1月至2015年3月收治的47例青年期下肢深静脉血栓病人的临床资料,均以静脉造影检查诊断。结果:危险因素中遗传性10例(21.3%),免疫性6例(12.8%),恶性肿瘤5例(10.6%),妊娠相关6例(12.8%),术后卧床等其他因素20例(42.6%)。47例病人中,4例采用不抗凝、不止血的中性治疗,19例单纯抗凝。24例抗凝结合下腔静脉滤器置入,其中71例在滤器保护下溶栓,2例溶栓并置入髂静脉支架。结论:血液高凝状态是青年期静下肢深静脉血栓形成的最常见危险因素,治疗以抗凝为主,必要时结合滤器置入、导管溶栓等腔内微创综合治疗。Objective To analyze etiologic factors for lower extremity deep vein thrombosis among patients younger than 35 years of age and to suggest recommendations for the treatment. Methods A total of 47 young patients with lower extremity deep vein thrombosis diagnosed by phlebography were retrospectively reviewed from Jan 2010 to Mar 2015. Resuits There were the risk factors which included inherited thrombophilia （21.3%, 10 cases）, immunologic （12.8%, 6 cases）, malignant （10.6%, 5 cases）, pregnancy-related （12.8%, 6 cases）, and others （42.6%, 20 cases）. Four cases were not given the treatment of anticoagulation and hemostasis, and 19 cases had only anticoagulation. The anticoagulation with inferior vena ca- va filters was given to 24 cases including 11 cases treated by thrombolysis with protection of filter placement and 2 cases by thrombolysis combined with iliac vein stent. Conclusions Hypercoagulable status is the most commonly observed risk factor among younger patients with lower extremity deep vein thrombosis. The anticoagulant therapy is mostly used. The other endovascular treatment including filters placement and catheter thrombolysis are added if necessary.

关 键 词：深静脉血栓 下肢 青年期 危险因素 治疗 

分 类 号：R543.6[医药卫生—心血管疾病]