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目的通过分析静脉血栓栓塞(VTE)的临床特征,为提高其诊断准确率与及早干预治疗提供依据。方法对广州三间教学医院15年来确诊的VTE患者的资料进行回顾性临床分析。结果343例(1992～2006)深静脉血栓形成(DVT)患者,发生于左下肢者(67.5%)多于右下肢者(26.1%)。主要致病危险因素,有年龄>40岁(89.2%)、卧床≥3 d(58.7%)、4周内行手术者(20.4%)、恶性肿瘤(16.8%)、糖尿病(12.3%)、曾发生静脉血栓病史者(11.1%),同时存在2个或2个以上危险因素者占40%。临床表现主要为患肢疼痛与压痛(49.4%)、下肢肿胀(69.9%)、患者小腿>健侧≥3 cm(55.8%)。肺栓塞(PTE)主要症状为胸痛(35.3%)、心率>100次/min(47.1%)。彩色多普勒血流显像(CDFI)对DVT和多层螺旋CT对PTE的辅助诊断效果佳。结论警觉DVT-PTE存在的致病危险因素,细致掌握临床表现,及时应用辅助诊断技术,可提高诊断水平并可加强干预治疗。
Objective To analyze the clinical features of venous thromboembolism (VTE) and provide the basis for improving the diagnostic accuracy and early intervention. Methods Retrospective clinical data of VTE patients diagnosed in three teaching hospitals in Guangzhou during 15 years were retrospectively analyzed. Results Of the 343 patients (1992-2006) with DVT, 67.5% were in the left lower extremity (26.1%) than in the right lower extremity. The main risk factors were age 40 years (89.2%), bed rest 3 days (58.7%), surgery 4 weeks (20.4%), cancer (16.8%), diabetes 12.3% The history of venous thrombosis (11.1%), while there are two or more than two risk factors accounted for 40%. The main clinical manifestations were pain and tenderness in the affected limbs (49.4%), swelling of the lower limbs (69.9%), and the lower leg> 3 cm (55.8%) in the healthy leg. The main symptoms of pulmonary embolism (PTE) were chest pain (35.3%) and heart rate> 100 beats / min (47.1%). Color Doppler flow imaging (CDFI) on DVT and multi-slice spiral CT on the diagnosis of PTE with good results. Conclusions Awareness of the risk factors of DVT-PTE, meticulous clinical manifestations, and the timely application of diagnostic techniques can improve the diagnostic level and can enhance the intervention.