378例下肢深静脉血栓形成患者获得性危险因素分析

The analysis of acquired risk factors in 378 patients with lower limb deep vein thrombosis

目的:总结分析下肢深静脉血栓形成患者临床表现和实验室特点,分类鉴别下肢深静脉血栓形成的获得性危险因素。方法:对我院2005年1月-2009年1月诊断的378例下肢深静脉血栓形成患者进行回顾性分析。结果:378例中发病有明确诱因者253例(67%),未发现明确诱因者104例(33%)。较常见的危险因素有外科手术/外伤(27.5%)、恶性肿瘤(15.3%)、妊娠(8.4%)、静脉曲张(8.4%)、长期住院卧床患者(5.3%)、风湿免疫性疾患(2.6%)。39例患者经肺血管造影确诊存在肺血管血栓形成,仅19例患者出现肺血栓栓塞相关临床表现如呼吸困难、咯血和胸痛。结论:手术/创伤,尤其是骨折和骨科手术,恶性肿瘤是下肢深静脉血栓形成的重要危险因素。并发肺栓塞的患者临床表现多变,诊断主要依赖肺血管造影检查。

Objective：To investigate clinical features and acquired risk factors for lower limb deep vein thrombosis.Method：Three hundred and seventy-eight patients with lower limb deep vein thrombosis （during 2005-2009） were analyzed retrospectively.Result：Among the patients,253 cases （67%） were presented acquired risk factors,and there was not known risk factors in 125（33%） cases. Major acquired risk factors were trauma/surgery （27.5%）,malignancy （15.3%）,pregnancy （8.4%）,varix （8.4%）,long-term immobilization in bed （5.3%） and autoimmunological disorders （2.6%）. Pulmonary embolism （PE） was identified in thirty-nine patients by pulmonary angiography. Among them,only 19 cases were presented with PE-related symptoms such as dyspnea,hemoptysis,chest pain.Conclusion：The trauma/surgery,especially fracture or osteological operations,and malignancy are the main acquired risk factors for lower limb deep vein thrombosis. Clinical symptoms of pulmonary embolism might be varied,and the diagnosis of PE was depended on pulmonary angiography.