深静脉血栓形成的研究进展

Research Development of Deep Vein Thrombosis

深静脉血栓形成（DVT）是骨科常见并发症之一，主要原因是血管内皮损伤、静脉回流减慢及血液高凝状态。DVT主要发生在下肢，且根据创伤或手术的不同，发生率也不尽相同，高危因素如年龄、肥胖、骨折、手术及人工材料的植入等。临床表现如肢体肿胀、疼痛、肌肉牵拉痛等，诊断借助超声多普勒及D-二聚体检测，静脉造影是诊断DVT的金指标。预防有物理及药物预防，物理措施如弹力袜，药物如低分子肝素，治疗主要是抗凝与溶栓，药物如尿激酶、组织纤溶酶原激活剂等，介入方法溶栓最好，并可置入临时性滤器以防止肺栓塞的发生。

Deep vein thrombosis （DVT） is one common complication of the orthopedic. Main reasons are the injury of blood vessel endothelium, vein reflux reduction and high coagulation. DVT is oeeurrod mainly in lower extremity. The incidence is different according to the injury or operation. The high-risk factors are related to age, fatness, fracture, operation and artificial material embedding, etc. The lower limb swelling, pain, tenderness of gastroenemius are the main clinical eharacteristies. The colour-code Doppler uhrasomography and Plasma D-dimer assay are the important methods of diagnosis. The venography is the golden standard. The physiotherapy （ as elastic socks） and medical （ including the low molecular weight heparin and low molecular dextran, ete） can prevent DVT. Antieoagulation and thrombolysisi are the methods of the treatment of DVT. The interventional thrombolysisi is best. The inferior vena cava filter is applied to prevent pulmonary embolism.