急性脑卒中患者静脉血栓栓塞症调查及危险因素探讨

<正>静脉血栓栓塞症(venous thromboembolism,VTE)包括深静脉血栓形成(deep venous thrombosis,DVT)和肺血栓栓塞症(pulmonary thromboembolism,PTE)。脑卒中患者是VTE发生的高危人群,如果不给予任何干预措施,30%~40%的脑卒中患者会发生DVT,严重

Survey of the Venous Thromboembolism and Risk Factors in Patients with Acute Stroke

Objective To survey incidence of venous thromboembolism（VTE） and risk factors in patients with acute stroke.Methods This is a prospective study at multi-centers.The ultrasonography is used for detecting both lower extremities vein in all patients at 10～14 days after the onset of stroke.The incidence of VTE was calculated.A variety of related factors were compared between stroke patients with VTE and without VTE to identify the VTE risk factors.Results The incidence of deep vein thrombosis（DVT） was 4.49% in patients with acute stroke.Among DVT patients,51.61% patients had DVT symptoms,and 48.39% patients had no DVT symptoms.Age（≥70years）,bedridden,wells score≥2,lower limbs NIHSS score≥3,high D-dimer,low BI scores,rehabilitation therapy or not,anticoagulant therapy or not（OR=1.63～4.85,P0.05、0.01）were independent risk factors of DVT in patients with acute stroke by multiple Logistic regression analysis.The rehabilitation therapy and anticoagulant therapy were protective factors among them.The incidence of pulmonary thromboembolism（PTE）was 0.80%,and 81.82% PTE patients were accompanied DVT.Age（≥70years）,bedridden and DVT（OR=1.78～5.62,P0.05、0.01）were independent risk factors of PTE in patients with acute stroke by multiple Logistic regression analysis.Conclusions The stroke patients are highrisk groups of VTE,especially the elderly stroke patients.Nearly half of DVT patients have not DVT symptoms and most of PTE patients are accompanied with DVT. The independent risk factors of VTE in stroke patients are various.It＇s necessary to supervise and prevent the VTE for the stroke patients with risk factors.The rehabilitation therapy and anticoagulant therapy may decrease the incidence rate of VTE.