住院患者深静脉血栓形成的临床特征

Clinical features of hospitalized patients with deep venous thrombosis

目的提高对住院患者深静脉血栓形成（DVT）临床特征的认识。方法回顾性分析首都医科大学附属北京世纪坛医院2007-2016年以非DVT入院且住院期间发现DVT患者的临床资料，总结人口学特征、流行病学特征、累及部位、科室分布、危险因素。结果期间以非DVT入院患者共305922例，其中5063例诊断DVT，累及5204个不同部位；男性2752例（54．36％）；年龄1—103（74．1±15．9）岁，DVT患者以80～89岁年龄段最多（37．78％，1913／5063），90—99岁患病率最高（7．32％，551／7523）。DVT总体患病率为1．65％，年患病率有逐渐升高趋势（从2007年的0．50％增至2016年的2．74％）。绝大多数DVT位于下腔静脉系统（96．54％，5024／5204），尤其是下肢深静脉（83．78％，4360／5204），肝门静脉发生率高（8．61％，448／5204），上腔静脉系统发生DVT少（3．46％，180／5204）。内科DVT患病率高于外科（2．95％比0．97％，P〈0．01），重症监护病房DVT患病率最高（9．75％）；产科、新生儿内科等少数科室无DVT发生。住院患者发生DVT的高危因素包括炎症性疾病（71．54％）、年龄≥75岁（67．25％）、心脏疾病（58．98％）等。结论有DVT高危因素患者，尤其是高危科室住院患者要加强DVT筛查，重视筛查肝门脉血栓形成。

Objective To increase the consciousness of incident deep venous thrombosis （DVT） in hospitalized patients. Methods This is a retrospective study of hospitalized patients with DVT in Beijing Shijitan Hospital from 2007 to 2016. Clinical features of DVT patients who were admitted with no DVT were summarized. The demographic and epidemiological characteristics, involved site of veins, department of patients and risk factors were discussed. Results A total of 5 063 patients were complicated with DVT from 305 922 inpatients who were without DVT at the admission during past 10 years. Among them, 54.36% （2 752 / 5 063） were men. The age of the patients was （74.1 ±15.9） years old （range 1- 103 years） with 37.78% of them in 80 to 89 age group. The incidence of DVT in the hospital was 1.65%. It increased yearly during the past decade （from 0.50% to 2.74%）, and increased with age in patients from 1 to 99 years old （7.32% in 90-99 age group）. Totally, 5 204 veins were involved in the patients. Most thrombosis involved inferior vena cava system （96.54%,5 024/5 204）, especially deep veins of lower extremity （83.78%,4 360/ 5 204）, some involved portal veins （8.61%,448/5 204） and a little was found in superior venae cava （3.46%, 180/5 204）. More DVT patients were in department of internal medicine than those in department of surgery （2.95% vs 0.97%, P〈0.01）. ICU had the highest rate of DVT among the hospital departments （9.75%）. No DVT occurred in department of newborn. Risk factors of DVT were inflammatory diseases （71.54%）, age over 75 years old （67.25%）, and heart diseases （58.98%）. Conclusion Sensitivity of detection on DVT should be emphasized in hospitalized patients with DVT risk, especially at the department with high incident of DVT.