深静脉血栓形成的危险因素及临床分析

Risk factors and clinical features of deep venous thrombosis: a report of 388 cases

目的 提高对深静脉血栓形成 (DVT)和肺血栓栓塞症 (PTE)的危险因素和临床特点的认识。方法 对 338例DVT患者的临床资料进行回顾性分析。结果 近 10年来住院患者中DVT患者的比例呈逐年上升趋势。 80 4 %的DVT患者存在危险因素。最常见的危险因素为年龄≥ 4 0岁(88 9% )、心脏病 (4 3 0 % )、高血压 (35 1% )、长期卧床 (2 1 1% )、感染性疾病 (2 0 1% )等。DVT最常见的临床症状为患肢肿胀 (6 6 2 % )和疼痛 (4 0 5 % ) ,87 2 %的患者两侧小腿周径差值≥ 1cm。DVT易累及左下肢 ,近端静脉多见。 34 5 %的DVT患者合并PTE ,其中 74 6 %以PTE为首发症状。DVT发生PTE的比率在左、右下肢及静脉远、近端之间差异无显著性。结论 DVT在住院患者中所占比例逐渐增加 ,大多数存在危险因素 ,DVT在并发PTE前常无明显症状 。

Objective To investigate the risk factors and clinical characteristics of deep venous thrombosis(DVT) and pulmonary thromboembolism(PTE). Method The clinical manifestations and risk factors in 388 patients with DVT were retrospectively studied. Results The ratio of DVT cases in hospitalized patients had a trend of increasing in recent years. 80.4% of the patients with DVT had risk factors. The most common risk factors were age over 40 years old(88.9%),heart disease(43.0%),hypertension(35.1%),long term immobilization(21.1%),and infection (20.1%). The most common clinical presentations of DVT were swelling (66.2%) and pain (40.5%) of the affected extremity. Calf swelling by more than or equal to 1 cm compared with the asymptomatic leg was found in 87.2% patients. The site of DVT was more common in left extremities and proximal veins. PTE was found in 34.5% of the DVT cases and 74.6% of them were diagnosed prior to DVT. The ratio of PTE caused by DVT didn′t show significant difference between left and right legs,neither between proximal and distal veins. Conclusions The ratio of DVT cases in hospitalized patients was increasing. Most patients with DVT had risk factors. DVT was usually asymptomatic before PTE was complicated.