妇科盆腔术后合并下肢深静脉血栓的早期诊治  

Early diagnosis and treatment of lower extremity deep venous thrombosis in patients following gynecological pelvic surgery

作　　者：陈学勤 梁双超[2] 奚旭霞 CHEN Xueqin LIANG Shuangchao XI Xuxia(Department of Gynecology ＆ Obstetrics, Wuhu No. 1 People＇s Hospital, Wuhu 241001, China)

机构地区：[1]芜湖市第一人民医院妇产科,安徽芜湖241001 [2]皖南医学院第一附属医院弋矶山医院血管外科,安徽芜湖241001

出　　处：《皖南医学院学报》2016年第4期361-363,共3页Journal of Wannan Medical College

基　　金：皖南医学院中青年科研基金项目(WK2013F10)

摘　　要：目的：探讨妇科盆腔术后合并下肢深静脉血栓早期诊治意义,预防肺栓塞的发生。方法：回顾性分析我院2010年1月~2015年10月912例妇产科手术后发生下肢深静脉血栓25例病历资料,结合临床表现,通过下肢血管超声检查、下肢静脉造影和D-二聚体检测,早期发现下肢深静脉血栓,给予抗凝溶栓治疗。结果：912例妇产科手术后发生下肢深静脉血栓25例,其中7例小腿肌肉静脉丛有2例下肢静脉造影未检出,2例髂静脉血栓有1例患者超声未检出,行深静脉造影发现;急性下肢深静脉血栓患者D-二聚体明显升高,25例患者均无肺栓塞发生。结论：D-二聚体是早期血栓最敏感指标,下肢深静脉血栓早期诊断需结合下肢血管超声检查和下肢静脉造影,早期诊断和及时治疗是预防肺栓塞发生的关键。Objective： To investigate the approaches to early diagnosis and treatment of lower extremity deep venous thrombosis（ LEDVT） in women following gynecological pelvic surgery for prevention of pulmonary embolism.Methods： Twenty-five of 912 patients complicated with lower extremity deep venous thrombosis underwent vascular ultrasound examination and phlebography as well as detection of the D-dimer level,and were treated with anti-coagulation and thrombolysis.Results： LEDVT was detected in 25 patients by deep venous phlebography.However,2 of 7 involved in the venous plexus in the muscles of the calf were failed by phlebography,and 1 in 2 involved in iliac veins by ultrasound.Elevated D-dimer level was found in acute LEDVT cases,yet no single case was complicated with pulmonary embolus.Conclusion： D-dimer concentration may be a sensitive index to early diagnosis of LEDVT besides ultrasonic examination and phlebography in the lower extremities,and early detection and treatment can prevent the incidence of pulmonary embolus in patients following gynecological pelvic surgery.

关 键 词：妇产科手术 下肢深静脉血栓 早期诊治 

分 类 号：R713[医药卫生—妇产科学]