缺血性脑卒中后下肢深静脉血栓形成的临床分析

目的　分析缺血性脑卒中后下肢深静脉血栓形成(LDVT)的主要发病原因,为临床采用合理的预防和治疗措施提供客观理论依据。方法　分析50例缺血性脑卒中并发LDVT患者的临床特点及血液凝血、抗凝和纤溶系统分子标志物指标的变化。结果　50例脑梗塞(CI)并发LDVT患者中, 65岁以上的占60%;卧床2~4周的发病率最高;伴发疾病中以高血压、高血脂最常见;与正常对照组相比,CI并发LDVT患者的vWF、GMP 140、F1+2含量,PAI 1活性均明显升高,而AT活性、总PS含量、PC活性、PLg活性均明显降低,差异均有非常显著性意义(P<0. 01~0. 001)。结论　高龄、卧床及血液的高凝状态是CI并发LDVT的主要因素。临床上应对高龄、长期卧床及存在高凝状态的CI病人,给予必要的抗凝、溶栓药物及早期康复锻炼等预防性措施,以防止LDVT的发生。

Clinical Analysis on Deep Vein Thrombosis in Lower Limb after Ischemia Stroke

Objective To investigate main reasons of lower limb deep vein thrombosis(LDVT) after ischemia stroke in order to find out reasonable stragegies for prophylaxis and treament.Method 50 cases of LDVT complicated with ischemia stroke were selected.Their clinical manifestations and changes of molecular markers of coagulant,anticoagulant and fibrinolytic parameters were analyed.Results Among 50 cases of LDVT,60% patients were over 65 years old.The incidence was highest in patients who lied in bed for 2~4 weeks.Hypertension and high blood lipid were common complications.The levels of vWF,GMP-140,F_(1+2 ) and PAI-1 in LDVT group were significantly higher than those in the controls.The levels of AT,PS PC and PLg in LDVT group were significantly lower than those in the controls(P<0.01~0.001).Conclusions Senility,sick bed and hypercoagulation are high risks of LDVT after ischemia stroke.In those who are old,who lie in bed for a long time and who have hypercoagulation,prophylaxis such as anticoagulatic therapy,thrombolytic therapy and early rehabilitation excercises should be adopted in order to prevent the incidence of LDVT.