摘要
目的探讨区域性中心医院下肢深静脉血栓形成(DVT)患者的疾病特点及诊疗趋势。方法回顾性分析西安交通大学第一附属医院血管外科2015年10月至2018年10月收治的下肢DVT患者的临床资料,包括年龄、性别、临床表现、血栓发生部位、符合DVT危险因素的人群比例及其治疗方案。结果共1032例DVT患者,其中男性501例,女性531例。急性期患者为65.02%(671/1032)。临床特点:(1)DVT易累及左下肢;(2)混合型血栓最常见(76.48%,868/1135);(3)符合DVT常见的危险因素有:年龄≥40岁(91.28%,942/1032)、合并心脑血管病史(36.72%,379/1032)、创伤/手术史(27.33%,282/1032)、久坐卧史(22.38%,231/1032)、男性吸烟史(43.51%,218/501)等;(4)DVT也常见于手术后患者:骨科手术(47.73%,84/176)、妇产科手术(14.77%,26/176)、普外科手术(13.07%,23/176)、血管外科手术(7.95%,14/176)、泌尿外科手术(7.39%,13/176)及神经外科手术(3.98%,7/176)。(5)急性期患者D-二聚体明显升高(90.57%,586/647),而慢性期患者D-二聚体明显升高的比例仅63.19%(115/182)。治疗趋势方面:(1)预防性下腔静脉滤器植入率为74.71%(771/1032);(2)急性期患者中有22.95%(154/671)接受了导管溶栓,低分子肝素作为院内抗凝药物的使用率逐年升高;(3)院外治疗方案中利伐沙班逐渐代替传统的华法林,成为常规抗凝药物。结论下肢DVT在本区域中心医院发病率高,危险因素复杂,需要得到重视,关于DVT的诊疗规范性仍需得到加强。
Objective To investigate the characteristics of the disease and the trend of diagnosis and treatment of patients with deep venous thrombosis(DVT)admitted to the First Affiliated Hospital,Xi'an Jiaotong University from October 2015 to October 2018.Methods The clinical data such as age,gender,clinical manifestations,location of thrombosis,and proportion conforming to DVT risk factors and treatment trends of patients with DVT were analyzed retrospectively.Results There was no difference in the prevalence between men and women in 1032 patients with DVT.Patients in the acute phase were more common,accounting for 65.02%(671/1032).DVT was easy to accumulate left lower limbs,and the hole limb type was the most common type of thrombus,accounting for 76.48%(868/1135).The common risk factors for DVT were age≥40 years(91.28%),history of cardiovascular and cerebrovascular disease(36.72%),history of trauma/surgery(27.33%),history of sedentariness(22.38%),history of smoking in male(43.51%),etc..The most common types of surgery were orthopedic surgery(47.73%),gynecologic surgery(14.77%),general surgery(13.07%),vascular surgery(7.95%),urology surgery(7.39%)and neurosurgery(3.98%).In the acute phase,90.57%of the D-dimer mers were≥1,while in the chronic phase,only 63.19%of the D-dimer mers were≥1.In terms of treatment,the use of preventive recyclable filters has increased year by year.Among the patients in the acute phase,22.95%(154/671)received catheter thrombolysis.In the long-term treatment plan,rivaroxaban gradually replaced the traditional warfarin and became a conventional anticoagulant.Conclusion The DVT of the lower extremities is currently high in our region,the risk factors are complex,and needs to be taken seriously.The standardization of diagnosis and treatment of DVT still needs to be strengthened.
作者
王崴屹
蔡惠
陈晋星
陈冰宜
李延
禄韶英
Wang Weiyi;Cai Hui;Chen Jinxing;Chen Bingyi;Li Yan;Lu Shaoying(Department of Vascular Surgery,the First Affiliated Hospital,Xi’an Jiaotong University,Xi’an 710061,China)
出处
《中华血管外科杂志》
2019年第2期88-92,共5页
Chinese Journal of Vascular Surgery
关键词
深静脉血栓
危险因素
治疗趋势
回顾性研究
Deep venous thrombosis
Risk factors
Treatment trends
Retrospective studies
