下肢深静脉血栓形成的临床流行病学研究

The clinical epidemiology of deep venous thromboembolism in the lower extremities

目的探讨国人下肢深静脉血栓形成（deep venous thrombosis，DVT）的流行病学特点。方法对经下肢深静脉顺行造影确诊的2742例DVT患者的临床资料进行回顾性分析。结果在下肢静脉疾病中，DVT占22．39％。男女之间患病率无差异；DVT常见临床症状是患肢肿痛（92．34％），浅静脉曲张（32．57％），皮肤色素沉着（24．95％），及溃疡形成（18．45％）。DVT易累及左下肢；混合型最常见，占60．09％。80．23％的DVT患者存在危险因素。最常见的危险因素是年龄≥40岁（76．29％）、手术操作史（12．18％）、严重创伤史（8．42％）、妊娠和产褥期（4．87％）等。最常见的手术类型依次为普通外科手术（26．05％），血管外科手术（23．35％），妇产科手术（20．96％），骨科手术（16．47％）和泌尿外科手术（7．49％）。原发性血液高凝综合征占全部DVT患者的0．22％。结论DVT占下肢静脉疾病的22．39％，临床症状以患肢肿痛最多见。DVT主要危险因素有年龄≥40岁、手术操作和严重创伤史。原发性血液高凝综合征是DVT不可忽略的危险因素。

Objective To investigate the risk factors and clinical characteristics of deep venous thromboembolism （DVT） of the lower extremities in Chinese people. Methods The clinical manifestations and risk factors in 2742 DVT patients diagnosed by phlebography were retrospectively studied. Results DVT made up 22. 39% of all the venous diseases of the lower extremity. The most common clinical presentations of DVT were swelling and pain （92. 34% ） , varicose vein （32. 57% ） , pigmentation （24.95%） and ulceration（ 18. 45% ）. The left lower extremity was more frequently involved. The whole limb type was 60. 09% , 80. 23% DVT patients had identified risk factors including age over 40 years old （76. 29% ）, history of major surgery （12. 18% ） and severe trauma （8.42%）, pregnancy and the puerperium （ 4. 87% ）. The history of general surgery （ 26.05% ） , vascular surgery （ 23.35% ） , gynaecology and obstetrics （20. 96% ） , orthopaedics （16. 47% ） and urinary surgery （7.49%） was among the most common surgery. Primary hypercoagulable syndrome was identified in 0. 22% DVT patients. Conclusion DVT makes up 22. 39% of the disease of veins of the lower extremity. The most common clinical presentations of DVT were swelling and pain. The most common risk factors were age over 40 years, major surgery, severe trauma. Primary hypercoagulable syndrome is a heritage risk factor for DVT pathogenesis.