颅脑术后下肢深静脉血栓形成的诊治

Diagnosis and treatment of deep venous thrombosis of lower limbs after craniocerebral operation

目的探讨对颅脑术后下肢深静脉血栓形成（DVT）的诊治。方法回顾性分析我院2004年6月。2006年6月42例颅脑术后下肢深静脉血栓形成患者临床资料。结果42例患者行抗凝治疗30例，溶栓治疗4例，下腔静脉滤器置入13例，所有患者下肢肿胀疼痛症状均缓解，下肢血管彩色多普勒超声检查示血栓全部再通者3例，部分再通者15例。结论颅脑术后患者为下肢DVT中高危患者，血浆D-二聚体的检测及血管彩色多普勒超声检查相结合能够有效地诊断DVT的发生，抗凝治疗为主要方法，慎用溶栓药物，下腔静脉滤器置入对防止肺栓塞发生有重要作用。

Objective To discuss the diagnosis and treatment of deep venous thrombosis（ DVT） of lower limbs after craniocerebral operation.Methods Forty-two cases of DVT of lower limbs after craniocerebral operstion from June 2004 to June 2006 were reviewed.Results Among 42 cases,30 underwent anticoagulation therapy, 4 received thrombolytic agents, and 13 were implanted with inferior vena cava filter. The swelling and pain in lower limbs in all the patients were relieved. The vascular color Doppler uhrasonography showed rec, recanalization in 3 cases and partial recanalization in 15 cases.Conclusions Thepatients after craniocereixal operation are at high risk d DVT d lower limbs. It is effective to diagnose the DVT by determining plasma d - dimex together with vascular color Doppler uhrasonography. The therapy consists of anticoagulation as the first priority, thrombolytic agents with caution, and the implantation of inferior vena cava filter as an important procedurce to prevent pulmonary embolism.