下肢深静脉血栓形成35例分析

Analysis of 35 cases of deep vein thrombosis development in lower extremity

目的探讨下肢深静脉血栓形成（DVT）的病因、治疗方法及预防。方法对该院2004~2009年收治的35例深静脉血栓形成患者进行回顾性分析,所有病例均经彩色多普勒和D二聚体检查确诊。35例患者分为常规组和溶栓组：常规组以低分子肝素、华法林加疏血通治疗;溶栓组在常规组治疗的基础上加尿激酶溶栓治疗。结果由肿瘤引起10/35例占28.6%,由手术后引起1/35例占2.9%,由糖尿病引起8/35例占22.9%,由感染引起1/35例仅占2.9%。常规组有效率89.5%,溶栓组有效率93.8%,总有效率91.7%。左侧下肢深静脉血栓共28例占80%。结论肿瘤、手术后和糖尿病是DVT的常见病因。抗凝和溶栓治疗是DVT安全、有效的首选治疗方法,无1例发生严重出血及肺栓塞。溶栓治疗疗效不佳时可采用非药物治疗,如予支架置入术或经皮血栓切除术。高危或术后患者应予以早期预防。

【Objective】 To explore the aetiology,treatment and prevention of deep venous thrombosis（DVT） in lower extremity.【Method】 Thirty-five patients with DVT who admitted in our hospital in recent years（from the year 2004 to 2009） were retrospectively analyzed.All cases were confirmed by colour Doppler and D-Dimer.Patients in the routine group were treated with low molecular heparin,warfarin and shuxuetong.Based on this treatment,urokinase was additionally added to the thrombolysis group.【Result】 Ten cases were cancer（28.6%）,9 cases were after surgery（25.7%）,8 cases were diabetics,only 1 case was infection The effective rate was 89.5% and 93.8% for the routine and the thrombolysis group,respectively.The total effective rate for all cases was 91.7%.28 cases were deep vein thrombosis in left lower extremity（80%）.【Conclusion】 Cancer,after surgery and diabetes are the common causes of DVT.Anticoagulation and thrombolysis are the safe,effective first line therapeutic choice.When they don＇t work,stent implantation and percutaneous removal of thrombus should be considered as alternatives.Early preventions should be given to the patients with high risk or after surgery.