41例合并深静脉血栓患儿的抗凝治疗分析

Anticoagulant Therapy Analysis of Kidney Diseases Complicated with Deep Venous Thrombosis in 41 Cases of Children

目的:总结肾内科合并深静脉血栓住院患儿的抗凝治疗情况,为临床药师参与治疗提供参考。方法:收集我院肾内科2010年1月至2016年1月合并发生深静脉血栓的患儿41例,对发生血栓的原因及部位、原发疾病、抗凝治疗用药情况等临床资料进行总结分析。结果:我院肾内科住院患儿合并深静脉血栓比例为0.41%(41/10 043)。41例合并深静脉血栓的患儿平均年龄6.9岁,以男孩居多(31例);自发性血栓24例,插管相关性血栓17例。血栓发生部位分布依次为下腔静脉10例,下肢静脉7例,股静脉7例,颅内血栓6例,髂静脉5例,肾静脉4例,上肢静脉4例,颈静脉1例,肝内血栓1例,其中4例患儿合并两处血栓。抗凝治疗疗程69(3~379)d,41例患儿(100%)全部使用了低分子肝素,37例患儿(90.24%)联用了尿激酶,18例患儿(43.90%)加用了华法林钠。结论:肾内科患儿合并深静脉血栓,我院抗凝治疗倾向于低分子肝素联合尿激酶,效果较好。

Objective：To summarize the general situation of anticoagulant therapy for kidney disease complicated with deep venous thrombosis（DVT） of hospitalized children.Methods：The clinical data of children in nephrology department of our hospital complicated with DVT from January 2010 to January 2016 were retrospectively analyzed.The causes and locations of thrombosis,primary diseases and medication of anticoagulant drugs were analyzed and compared.Results：Totally 41 children complicated with DVT were found in our study.Boys were in the majority,the mean age was 6.9 years old.Spontaneous thromboembolism were 24 cases,cannula relative were 17 cases.The locations of thrombosis were inferior vena cava（10 cases）,lower extremity vein（7 cases）,femoral vein（7 cases）,intracranial thrombosis（6 cases）,iliac vein（5 cases）,renal vein（4 cases）,upper limb vein（4 cases）,jugular vein（1 case）,hepatic thrombosis（1 case）,4 cases of which had two thrombus.The course of anticoagulant therapy was 69（3~379） d,all the 41 children used low molecular heparin,37 cases（90.24%） combined used urokinase,18 cases（43.90%） used warfarin.Conclusion：The combination of thrombus in the nephrology department is more common,and the anticoagulant therapy in our hospital is inclined to use low molecular heparin combined with urokinase,and the effect is better.