术后静脉血栓栓塞症

目的了解术后静脉血栓栓塞患者的特点,为临床预防和治疗提供参考。方法选取1997年1月-2004年8月诊治的47例术后下肢深静脉血栓形成的患者,并对资料作一回顾性分析。结果关节、脊柱、创伤手术是引起术后静脉血栓栓塞的高危因素;术后下肢深静脉血栓形成的发生有两个高峰:术后3 d内和10 d后;肺栓塞占静脉血栓栓塞患者的27．7％,均见于中央型和/或混合型下肢深静脉血栓形成患者。单纯抗凝治疗下肢深静脉血栓痊愈10例(21．3％),显效 18例(38．3％),有效19例(40．4％);肺栓塞者痊愈5例(38．5％),显效4例(30．8％),有效4例 (30．7％)。下肢深静脉血栓复发者5例,肺栓塞复发者2例,瓣膜功能未恢复者3例。结论 (1) 静脉血栓栓塞症高危患者需行手术和发生创伤时,应采取措施预防静脉血栓栓塞症。(2)注意术后迟发性下肢深静脉血栓形成。(3)两种影像学辅助检查相互配合可提高静脉血栓栓塞症的诊断。

Postoperative venous thromboembolism

Objective To study the patients of postoperative venous thromboembolism(VTE) and find a way to prevent VTE. Methods Aseries of 47 patients with deep venous thromboembolism (DVT) treated from January 1997 to August 2004 were retrospectively analyzed. Results The surgery of joint, spine and trauma were the high risk factors.There were two peak of VTE:in three days of postoperation and afier ten days of postoperation.They were central type or mixed patients. Of the 47 cases with DVT,27.7% were diagnosed as pulmonary embolism (PE).Purely treated with anticoagulant of DVT patients'result as follow: 21.3% folly recover,38.3% excellent effect,40.4% good result.And PE patients'result as follow: 38.5% fully recover, 30.8% excellent effect,30.7% good result. During follow-up,5 cases of DVT relapse, and 2 cases of PE were so.Conclusion (1)Prophylaxis way should be taken to prevent VTE while VTE high risk patients were operated or had trauma. (2)Pay attention to late occurrence DVT events. (3)Two kinds of screenage assist examination can help to diagnose VTE correctly.