下肢非深静脉血栓性肿胀的病因学探讨

Study on etiology of swelling in lower extremities without deep venous thromboembolism

目的探讨下肢非深静脉血栓性肿胀的病因。方法回顾性总结2000年1月至2007年12月我院收治的44例一度误诊为下肢深静脉血栓形成患者的临床资料。所有病例在详细询问病史和仔细体格检查后,部分病例进行了彩超、下肢深静脉造影、CT、MR、同位素淋巴扫描等检查,以期追踪下肢肿胀的病因。结果 44例下肢肿胀病例中,其中髂静脉受压综合征10例;股静脉血管内皮瘤1例;髋关节滑膜囊肿6例;下肢自发性出血、血肿8例;体位性骨筋膜室综合征1例;盆腔恶性肿瘤7例;良性纤维瘤病3例;厌氧菌感染5例;慢性淋巴水肿3例。结论下肢非深静脉血栓性肿胀并不少见,病因各异;仔细的病史采集和体格检查有助于诊断建立;静脉造影等影像学检查可明确诊断。

Objective To investigate the etiology of swelling in lower extremities without deep venous thromboembolism.Methods The data of 44 patients with swelling in the lower extremities who were misdiagnosed with deep venous thrombosis from January 2000 to December 2007 were retrospectively studied,in order to explore the etiology of swelling in lower extremities.All cases were studied by medical history and physical examination,and some of them were performed color ultrasonography,venography,CT,MR and radionuclide lymphoscintigraphy and so on.Results In all of 44 cases who were examined by imaging detection,were finded Cockett's syndrome in 10 cases,hemangioendothelioma of femoral vein in 1 case,hip cyst in 6 cases,spontaneous bleeding or hematoma of the muscle in 8 cases,fascial compartments syndrome in 1 case,malignant tumor of pelvic in 7 cases,benign fibroma of pelvic in 3 cases,anaerobic bacteria infection in 5 cases,chronic lymphoedema in 3 cases.Conclusions Swelling of lower extremities without deep venous thromboembolism is comman in clinical practice,but the etiologic finding are various absolutely.It is easy to establish diagnosis depending on some imaging examination after inquiring medical history and physical examination carefully.