98例老年急性下肢深静脉血栓形成的诊治分析  

Diagnosis and treatment analysis of acute deep venous thrombosis at lower extremity of 98 aged patients

作　　者：张光军[1] 虞贞凤[1] 周文华[1] 姚凯[1] 李成磊[1] 单远洲[1] 张学利[1] 

机构地区：[1]上海交通大学附属第六人民医院南院上海市奉贤区中心医院普外科,上海201499

出　　处：《中国普外基础与临床杂志》2017年第6期732-735,共4页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的总结老年急性下肢深静脉血栓形成(DVT)的临床特点及诊治经验。方法回顾性分析笔者所在医院于2012年1月至2014年12月收治的98例老年急性下肢DVT患者的临床资料。结果老年DVT患者发病至就诊时间为1~10 d,平均4 d;其主要症状为进行性加重的下肢肿胀。所有患者接受个体化的规范的以抗凝为主的综合治疗。出院后96例患者获访,随访率为98.0%,随访时间为12~24个月(平均18个月)。治疗后3个月96例患者患肢的临床严重程度评分(venous clinical severity score,VCSS)和患肢周径变化(患肢大腿中部周径变化和患肢小腿中部周径变化)与治疗前相比均有显著改善(P<0.001)。96例患者中,治愈9例,显效81例,有效6例。住院及随访期间本组患者均无致死性肺动脉栓塞(PE)发生,且无严重出血并发症发生;随访期间无DVT复发。结论老年急性DVT患者就诊晚,采用个体化的规范的以抗凝治疗为主的综合治疗是安全和有效的。Objective To summarize the clinical features, diagnosis, and treatment of acute deep venous thrombosis （DVT） at lower extremity of aged patients. Method Clinical data of 98 aged patients with acute DVT at lower extremity who got treatment in our hospital from Junuary 2012 to December 2014 were analyzed retrospectively. Results Of 98 aged patients with acute DVT at lower extremity, the time from disease developed to treatment was 1 day to 10 days with an average of 4 days. The main symptom was low limb swelling progressively. All the patients were treated by the comprehensive treatment based on individual anticoagulation. A total of 96 patients （98.0%） were followed up, and the follow-up period ranged from 12 months to 24 months （average of 18 months）. Of 96 patients followed-up, we found a statistically significant difference between lower extremities before treatment and those at 3 months after treatment in venous clinical severity score （VCSS） and the change of lower extremity circumference （P〈0.001）. Of 96 patients, 9 patients were cured, 81 patients had markedly effective results, and 6 patients had effective results. None of the patients suffered from fatal pulmonary embolismin in duration of hospital day and follow-up period, and no one suffered form DVT recurrence. Conclusions The aged patients with acute DVT at lower extremity usually see a doctor lately. The comprehensive treatment based on individual anticoagulation is safe and effective in treatment of acute DVT at lower extremity of aged patients.

关 键 词：下肢急性深静脉血栓形成 老年患者 诊断 治疗 

分 类 号：R543.6[医药卫生—心血管疾病]