急性脑卒中患者下肢深静脉血栓形成66例临床分析

Clinical analysis for acute stroke patients in 66 cases with deep vein thrombosis

目的：探讨急性脑卒中患者下肢深静脉血栓形成（ DVT）的危险因素和临床特征、辅助检查特点、治疗及预后等，以期为住院脑卒中患者DVT的早期预防、早期诊断和早期治疗提供详细的临床资料。方法回顾性分析160例脑卒中患者的临床资料，对其中66例脑卒中后偏瘫并经超声检查证实的DVT患者资料与同期收治的94例非DVT卒中患者进行对比分析，探讨DVT的发生率、发生时间及可能的危险因素，总结其临床特点。结果脑卒中患者发生下肢DVT的时间平均为16 d。 DVT发生于高龄患者（≥65岁）44例，占66．67％；严重瘫痪者42例，占72．72％；长期卧床者52例，占78．78％；伴发疾病中以糖尿病、高血压、高脂血症为常见；DVT患者的平均血浆纤维蛋白原浓度为（5．02±1．38） g／L，明显高于非DVT组的（2．74±1．65）g／L，差异有统计学意义（t＝4．78，P＜0．01）。结论肢体瘫痪、长期卧床、高龄、血浆纤维蛋白原浓度增高等是发生下肢DVT的高危因素，临床上对此类患者应给予提前预防。

Objective To investigate the risk factors and clinical characteristics,auxiliary examination char-acteristics,treatment and prognosis for acute stroke patients with deep vein thrombosis （DVT）,in the hope of provi-ding the detailed clinical data for hospitalized patients with stroke in early prevention,early diagnosis and early treat-ment of DVT.Methods 160 cases of stroke patients were reviewed including 66 cases of patients with hemiplegia after stroke and ultrasound confirmed DVT data analysis,And compared with the same period of 94 cases of DVT in patients with stroke.The purpose of this study was to evaluate the incidence of DVT,possible risk factors,and clinical characteristics.Results Stroke in patients with DVT spent an average of 16d.DVT occurred in elderly patients （65 years or higher） with 44 cases,accounting for 66.67%;Serious paralytic 42 cases （72.72%）,long-term bed 52 cases （78.78%）;The most commonly comorbid disease was diabetes mellitus,hypertension and hyperlipidemia;The plasma fibrinogen concentration was （5.02 ±1.38） g/L,which was significantly higher than （2.74 ±1.65） g/L of the control group.Compared with control group,the difference was statistically significant （t=4.78,P〈0.01）. Conclusion Limb paralysis,long-term lie in bed,older age and high condensation state are DVT risk factors,which should be paid to prevent in advance clinically.