上下肢深静脉血栓患者的临床特征对比

Comparisons on the clinical characteristics of 1243 patients with upper or lower extremities deep vein thrombosis

目的对比分析上肢深静脉血栓(UEDVT)和下肢深静脉血栓(LEDVT)患者的临床特征,为临床治疗护理工作提供研究依据。方法回顾性调查2017年1月至2018年10月某医院以深静脉血栓(DVT)为诊断的1243份病历,其中单纯UEDVT患者188例,单纯LEDVT患者1059例。对两类患者的一般资料、DVT风险因素、实验室检查结果进行对比分析。结果UEDVT患者的年龄和体重指数小于LEDVT患者,入院距血栓发生时间短于LEDVT患者,而住院天数及手术距血栓发生时间则长于LEDVT患者,差异均有统计学意义(P<0.05);UEDVT患者中合并恶性肿瘤、呼吸系统疾病、糖尿病、高血压、心血管系统疾病及吸烟、饮酒、经外周静脉置入中心静脉导管(PICC)比例高于LEVDVT患者,而血栓史、手术及手术史的比例低于LEDVT,差异均有统计学意义(P<0.05)。UEDVT患者的空腹血糖(FBG)、血小板计数(PLT)水平高于LEDVT,而总胆固醇(TC)、低密度脂蛋白(LDL)、C反应蛋白(CRP)、红细胞沉降率(ESR)水平低于LEDVT,差异均有统计意义(P<0.05)。结论UEDVT与LEDVT患者在临床特征方面存在一定差异,这提示着其风险因素和病理机制可能不同,临床医护人员应根据其差异性合理制订预防和治疗策略。

Objective To compare and analyze the clinical characteristics between the patients with upper-extremity deep vein thrombosis(UEDVT)and lower-extremity deep vein thrombosis(LEDVT),so as to provide research basis for clinical treatment and nursing.Methods 1243 cases with deep vein thrombosis(DVT)diagnosed in a hospital from January 2017 to October 2018 were retrospectively investigated,including 187 cases with single UEDVT and 1059 cases with single LEDVT.The general data,the risk factors of DVT and the laboratory test results between the patients were compared and analyzed.Results The age of UEDVT patients was younger than that of LEDVT patients,the time from thrombosis to admission was shorter than that of LEDVT patients,while the time of hospitalization and the time from thrombosis to operation were longer than that of LEDVT patients,the differences were statistically significant(P<0.05).The proportions of UEDVT patients with malignant tumor,respiratory system disease,diabetes,hypertension,cardiovascular system disease,smoking,drinking and peripherally inserted central venous catheter(PICC)were higher than those of LEDVT patients,while the proportions of thrombus history,operation or operation history were lower than those of LEDVT patients,the differences were statistically significant(P<0.05).The fasting blood glucose(FBG)and platelet count(PLT)of UEDVT patients were higher than those of LEDVT patients,while the levels of total cholesterol(TC),low density lipoprotein(LDL),C-reactive protein(CRP),erythrocyte sedimentation rate(ESR)were lower than those of LEDVT(P<0.05).Conclusion There are some differences in the clinical characteristics between UEDVT and LEDVT patients,which suggests that the risk factors and the pathological mechanism may be different.The clinical medical staff should make reasonable prevention and treatment strategies according to the differences.