剖宫产术后下肢深静脉血栓形成14例临床分析

Clinical analysis of 14 cases of lower extremity deep venous thrombosis after cesarean section

目的 通过分析剖宫产术后下肢深静脉血栓形成的发病情况,探讨其防治措施. 方法 对2010年1月至2013年12月宝鸡市妇幼保健院收治的14例剖宫产术后发生下肢深静脉血栓的病例资料进行回顾性分析. 结果 对14例患者均经彩超确诊为下肢深静脉血栓;其中初产妇9例,经产妇5例;发病时间在术后2-4天;有13例为单纯剖宫产术后发生下肢深静脉血栓,1例为剖宫产术中大出血行双侧髂内动脉栓塞术后发生下肢深静脉血栓. 对14例患者采用抗凝、溶栓治疗及护理干预,分别于发病后14-16天痊愈,无下肢静脉血栓脱落导致的肺栓塞、猝死等并发症发生. 结论 下肢深静脉血栓多于产褥早期发病,产后早下床活动可减少深静脉血栓形成,抗凝及溶栓是治疗下肢深静脉血栓形成的有效方法.

Objective To analyze the incidence of lower extremity deep venous thrombosis （ LE-DVT ） after cesarean section and to investigate the prevention and treatment measures.Methods A retrospective analysis was conducted on clinical data of 14 cases of LE-DVT after cesarean section from January 2010 to December 2013 in Baoji Maternal and Child Health Hospital.Results Fourteen patients were diagnosed as LE-DVT by color Doppler ultrasonography, including 9 cases of primipara and 5 cases of multipara.The onset time was 2 to 4 days after operation.There were 13 cases of LE-DVT after simple cesarean section and 1 case after bilateral internal iliac artery embolization due to massive hemorrhage during cesarean section.All patients were treated with anti-coagulation, thrombolytic therapy and nursing intervention, and they recovered in 14-16 days after the onset of the disease.No pulmonary embolism or sudden death was caused by LE-DVT occurred.Conclusion The occurrence of most LE-DVT happens at early puerperium, and early ambulation can prevent deep vein thrombosis.Anti-coagulation and thrombolysis therapy are effective methods in treatment of LE-DVT.