下肢深静脉血栓发病的高危因素

Analyses of risk factors for deep vein thrombosis in lower extremities

目的探讨下肢深静脉血栓形成（DVT）发病的相关高危因素。方法对2010年1月至2012年12月期间在成都军区昆明总医院血管外科住院的1264例下肢DVT患者的临床资料进行回顾性分析。结果1264例患者当中，年龄≥40岁的有984例，占77．85％；无明显诱因发病的有642例，占50．79％；发病前有明确外伤史（未行手术治疗）的142例，占11．23％；手术后发病的有316例，其中骨科手术史142例，占11．23％；妇产科手术史90例，占7．12％；普外科手术史42例，占3．32％；血管外科手术史23例，占1．82％；泌尿外科手术史12例，占0．94％；其他手术7例，占0．55％；慢性疾病长期卧床后发病的有10例，占0．79％；妊娠期或产褥期发病的有20例，占1．58％；恶性肿瘤患者25例，占1．98％；类风湿关节炎长期使用激素后发病的有10例，占0．79％；继发于下肢静脉曲张的有27例，占2．14％；吸毒史8例，占0．63％；抑郁症2例，占0．16％；下肢DVT复发的62例，占4．9％。结论下肢深静脉血栓形成成因影响因素较多，因此重在预防。对于存在高危因素的患者，应加强DVT的防治。

Objective To explore the risk factors of deep vein thrombosis （DVT） in lower extremities. Methods Retrospective data analyses were performed for a total of 1264 DVT patients at our department from January 2010 to December 2012. Results Among them, 984 cases （77. 85% ） were over 40 years old, no overt cause was found for 642 cases （50. 79% ） , 142 cases （ 11.23% ） had a clear history of trauma before onset （without surgery）. Among 316 recurrent postoperative cases, there were the surgical histories of orthopedics （n = 142, 11.23% ）, gynecology （n = 90, 7.12% ） , general practice （n = 42, 3.32%）, vascular （n=23, 1.82%）, urological （n=12, 0.94%） and others （n=7, 0.55%）.Ten cases （0. 79% ） occurred after suffering bedridden chronic diseases. And 20 cases （ 1.58% ） were caused by conditions during pregnancy or postpartum period, had Malignant tumors were found in 25 （1.98%） patients. After long-term uses of hormones, 10 patients （0.79%） of rheumatoid arthritis had a recurrence. Owing to varicose veins, 27 patients （2. 14% ） recurred. Eight patients （0. 63% ） had a history of drug abuse, 2 cases （0. 16% ） suffered depression and 62 cases （4. 9% ） were recurrent. Conclusion There are many causative factors of DVT so that prevention is of great importance. We should pay more attention to the prevention and treatment of high-risk DVT patients.