胸外科术后重症患者下肢深静脉血栓形成及其凝血状态分析

Analysis of Deep Venous Thrombosis and Coagulation Status of Lower Extremity in Severe Patients after Thoracic Surgery

目的对胸外科术后重症患者下肢深静脉血栓形成及其凝血状态进行分析。方法选取该院2017年1月-2018年1月入治的共100例胸外科术后重症患者,根据患者的各项指标内容,针对性进行下肢深静脉血栓形成及凝血状态的分析。结果 2例患者出现DVT,共有30条肢体,其中左下肢共10例,右下肢共4例,双侧共8例,所有患者DVT小腿血栓,平均发现时间分布为1~15 d,平均时间为(5.67±2.12)d,发病位置肺部恶性肿瘤占比26.42%,食道肿瘤占比16.42%,重症肌无力25.35%,其中恶性肿瘤出现DVT概率为24.21%,非恶性肿瘤出现DVT概率为18.56%。发生血栓及未发生血栓活化部分凝血活酶时间有显著差异外,其他组间差异无统计学意义,活化部分凝血酶时间,发生下肢DVT患者为(46.3±4.27),未发生下肢DVT患者为(39.3±4.21),组间对比差异有统计学意义(P<0.05)。结论胸外科术后重症患者通过物理预防方式干预后,下肢深静脉血栓仍然高发病率,对胸科术后患者进行血栓筛查有较高必要性。

Objective To analyze the deep venous thrombosis of lower extremity and its coagulation status in severe patients after thoracic surgery. Methods A total of 100 patients with severe thoracic surgery from January 2017 to January2018 were selected. According to the contents of the patients, the deep venous thrombosis and coagulation status of the lower extremities were analyzed. Results There were 30 limbs with DVT, in 2 patients, including 10 cases of left lower extremity, 4 cases of right lower extremity and 8 cases of bilateral thrombus. The average time of DVT leg thrombus was1 ≤ 15 days, with an average of(5.67 ±2.12) days. Pulmonary malignant tumors accounted for 26.42%, esophageal tumors 16.42%, myasthenia gravis 25.35%. The probability of DVT and DVT in malignant tumors and non-malignant tumors were 26.42%, 16.42% and 25.35%, 24.21% and 18.56%, respectively. There was no significant difference in the time of activated partial thromboplastin between the other groups and the other groups. The time of activated partial thrombus was(46.3 ±4.27) in patients with lower extremity DVT. There was no lower extremity DVT in patients with DVT(39.3 ±4.21). There was significant difference between the two groups(P<0.05). Conclusion After the intervention of physical prevention, the incidence of deep venous thrombosis of lower extremity is still high, so it is necessary to screen the thrombus after thoracic surgery.