急性脑梗死并发下肢深静脉血栓形成的临床分析

Clinical Analysis of Acute Cerebral Infarction Complicated with Deep Venous Thrombosis of Lower Extremity

目的 分析急性脑梗死并发下肢深静脉血栓患者的临床特点,以指导临床。方法 回顾性分析惠州市中心人民医院神经内科2020年1~12月收治的急性脑梗死并发下肢深静脉血栓患者的临床表现、治疗过程及预后。结果 共10例脑梗死并发下肢深静脉血栓患者纳入分析。10例患者均因D二聚体异常升高后完善双下肢血管彩超发现下肢深静脉血栓(100.00%),其中双下肢深静脉血栓4例(40.00%),右下肢深静脉血栓5例(50.00%)。仅1例患者有肢体肿胀表现,余患者均无明显相关症状。住院期间出现肺动脉栓塞1例(10.00%)。诊断DVT后口服利伐沙班抗凝治疗3例(30.00%),皮下注射低分子肝素1例(10.00%)。出院后随访复查下肢彩超发现深静脉血栓完全治愈3例(30.00%),深静脉血栓部分治愈2例(20.00%),死亡1例(10.00%)。结论 影响脑梗死患者发生深静脉血栓的因素众多,对危险因素评估后,深静脉血栓的发生风险高,早期预防治疗深静脉血栓对脑梗死患者的预后有很大的帮助。

Objective To analyze the clinical characteristics of patients with acute cerebral infarction complicated with deep vein thrombosis of lower extremity for clinical guidance.Methods The clinical manifestations,treatment process and prognosis of patients with acute cerebral infarction complicated with deep venous thrombosis of lower limbs admitted to the Department of Neurology of Huizhou Central People's Hospital from January 2020 to December 2020 were retrospectively analyzed.Results A total of 10 patients with cerebral infarction complicated with deep venous thrombosis of lower extremity were included in the analysis.Deep vein thrombosis was found in all the 10 patients due to the abnormal increase of D-dimer in both lower limbs by improved blood vessel color ultrasonography(100.00%),including 4 cases of DVT in both lower limbs(40.00%) and 5 cases of DVT in right lower limbs(50.00%).Only 1 patient had limb swelling,and the other patients had no obvious related symptoms.Pulmonary embolism occurred in 1 case(10.00%) during hospitalization.After diagnosis of DVT,3 cases(30.00%) were treated with oral rivaroxaban anticoagulation and 1 case(10.00%) with subcutaneous injection of low molecular weight heparin.After discharge,3 cases(30.00%)were completely cured of DVT,2 cases(20.00%) were partially cured of DVT,and 1 case(10.00%) died.Conclusion There are many factors that affect the occurrence of deep vein thrombosis in patients with cerebral infarction.After evaluating the risk factors,the risk of deep vein thrombosis is high.Early prevention and treatment of deep vein thrombosis is of great help to the prognosis of patients with cerebral infarction.