剖宫产术后深静脉血栓形成的临床研究

目的:探讨剖宫产术后DVT的诊治及预防。方法:回顾分析2002年8月至2005年12月我科收治的剖宫产术后并发下肢DVT的患者47例,分析其临床特点及诊断治疗的方法,并结合文献复习讨论预防措施。结果:既往有血栓病史、经产妇、肥胖是剖宫产术后DVT的危险因素,主要临床症状为患肢粗肿、疼痛,部分患者有呼吸系统的非特异性症状,DVT的辅助诊断首选血浆D-二聚体检测结合静脉彩色多普勒超声显像。采用全身或局部抗凝、溶栓等药物或手术取栓治疗,部分患者放置可回收性IVCF预防致死性PE,均取得较好的近期疗效。结论:对于存在DVT危险因素的孕产妇,剖宫产手术前后应采取积极预防措施。LMWH是常用的和安全的抗凝药物,能有效预防和治疗DVT。

Clinical investigation of postoperative deep venous thrombosis after caesarean section

Objective:To describe the clinical data of deep venous thrombosis (DVT) after Caesarean section and to study how to choose the methods of diagnosis ,treatment and prophylaxis of DVT.Methods:The clinical characteristics ,the methods of diagnosis and treatment of 47 cases with DVT were analyzed retrospectively.To review the previous literature and recommend the prophylactic steps.Results:The history of venous thromboembolism,fatness and multipara were the high risk factors for postoperative DVT.Combination of Plasma D-dimer and Doppler ultrasonography was the best choice to diagnose DVT definitely.Heparin or low molecule weight heparin (LMWH) anticoagulation was effective treatment in postoperative DVT.IVCFs were applied for the suspected patients to prevent fatal PE.Conclusions:The history of venous thromboembolism,fatness and multipara should be considered as high risk factors of the postoperative DVT.Preoperative or postoperative prophylatic treatment of DVT should be considered in high risk population.LMWH is used commonly and safe for DVT.IVCF can prevent fatal PE and Systemic therapy is essential for patients with DVT.