静脉血栓栓塞症高危因素和临床表现的荟萃分析

High risk factors and clinical manifestations of venous thromboembolism:a meta-analysis

目的:收集相关的文献资料,对静脉血栓栓塞症(VTE)患者的临床表现、危险因素进行荟萃分析。方法:查询中国生物医学文献库,查阅1999年至2009年中国期刊全文数据库(CNKI)、维普全文电子期刊中有关VTE的文献,对确诊为深静脉血栓形成(DVT)和肺血栓栓塞症(PTE)患者的一般情况、临床表现、高危因素等进行统计分析。结果:共纳入文献142篇,其中DVT相关80篇,PTE相关62篇;共计纳入患者9 049例,其中DVT患者6 296例,PTE患者2 753例。DVT患者的症状主要为患肢肿胀(68.23%)、疼痛(61.68%)、浅静脉曲张(16.95%)、下肢活动障碍(12.96%);PTE患者的主要临床表现为呼吸困难(61.00%)、胸痛(47.55%)、咳嗽(27.43%)、心率>100次/分(25.33%)等。DVT的危险因素包括年龄>40岁(92.72%)、手术(27.51%)、吸烟(18.56%)、心脏疾病(12.76%)、高血压(11.29%)、肿瘤(10.42%)等;PTE的危险因素则包括年龄>40岁(93.25%)、DVT史(33.97%)、心脏疾病(16.95%)、卧床(10.22%)、高血压(9.84%)。结论:通过了解VTE致病的危险因素,细致掌握具有一定特点的临床表现,可提高VTE的诊断水平,减少误诊、漏诊,并可及早开展干预治疗,降低病死率。

Objective To perform a meta-analysis of the high risk factors and clinical manifestations of venous thromboembolism（VTE）.Methods Literatures dealing with venous thromboembolism published between 1999 and 2009 were retrieved via CNKI Database and Wiki full text electronic version journal bank.A meta-analysis was performed on the high risk factors and clinical manifestations of patients with established diagnosis of deep vein thrombosis（DVT） and pulmonary thromboembolism（PTE）.Results One hundred and forty-two articles were available for analysis,including 80 articles of DVT and 62 articles of PTE.The most frequent manifestations of DVT were limb engorgement（68.23%）,pain（61.68%）,superficial varicose vein（16.95%）,limitation of lower extremity motion（12.96%）.Patients with PTE presented dyspnea（61.00%）,chest pain（47.55%）,cough（27.43%）,heart rate100/min（25.33%）.The risk factors of DVT included age40（92.72%）,operation（27.51%）,smoking（18.56%）,heart disease（12.76%）,hypertension（11.29%）,and tumor（10.42%）.The risk factors of PTE included age40（93.25%）,history of DVT（33.97%）,heart disease（16.95%）,bedfast（10.22%） and hypertension（9.84%）.Conclusions By paying attention to the risk factors and the characteristic manifestations of VTE,we could improve the diagnosis,decrease the misdiagnosis rate and give intervention treatment early,thereby reduce the death rate.