住院高危患者下肢深静脉血栓形成的患病率调查

目的 初步横断面调查上海中山医院住院高危患者下肢深静脉血栓形成的患病率,探讨与发病相关的高危因素.方法 对2008年9月至2009年2月期间上海中山医院神经内科卒中后卧床患者,骨科术后及妇科术后卧床患者,外科监护室患者,普外科结直肠癌手术及血管外科手术后卧床患者进行压迫超声筛查下肢深静脉血栓形成,初步计算整体及各科室患病率.收集详细的临床资料及阳性患者血栓部位、类型及累及肢体,应用统计学软件筛选相关的高危因素.结果 (1)本研究入组共372例,阳性38例,患病率为10.2%(38/372).(2)住院高危患者下肢DVT形成的高危因素分别为以30 d为界的卧床时间(P=0.000),凝血酶时间缩短(P=0.007)以及既往血管手术史(P=0.009).(3)神经内科患病率为12.7%(13/102),骨科10.0%(10/100),妇科6.3%(7/111).(4)妇科手术下肢DVT的高危因素为全子宫联合双附件切除术(P=0.032).结论 住院高危患者下肢DVT的患病率高,以左下肢和无症状患者居多,高危因素常为长期卧床、既往血管手术史以及凝血酶时间缩短,对于这些高危患者有必要强化预防性抗凝.

Preliminary study on epidemiology of deep venous thrombosis of lower extremity in patients with high risk

Objective To make preliminary cross-sectional study on epidemiology of deep vein thrombosis of lower extremity of inpatients with high risk in Zhongshan hospital,and analyze risk factors in these patients.Methods From Sep 2008 and Feb 2009,we performed compressed ultrasound to detect deep vein thrombosis of lower extremity of in-patients with high-risk in Zhongshan hospital,including bedrid stroke patients,post-surgery bedrid patients from department of orthopaedics,gynecology,general surgery and vascular surgery and patients of surgical intensive care unit.Prevalence rate of DVT of the whole study group as well as each department were calculated and analyzed.We collected detailed clinical information of each recruited patient.We made statistical single-factor and then Logistic regression multiple-factor analysis of these data with SPSS 16.0,to determine high risks of deep vein thrombosis of in-patients.Results (1)Totally 372 patients were enrolled in our study with 38 patients detected with DVT of lower extremity,so the prevalence rate of whole series was 10.2% (38/372).(2) High risks of lower extremity deep vein thrombosis for the whole series were bedrid time (30 day boundary) (P=0.000),thrombin time (P=0.007) and history of vascular surgery(P=0.009).(3) The prevalence rate of DVT of lower extremity of department of neurology,orthopaedics and gynecology were 12.7% (13/102),of 10.0% (10/100) and 6.3% (7/111)respectively.(4)High risk for DVT in pest-surgery gynecological patients was resection of uterus and both attachments (P=0.032).Conclusion In our study,the prevalence rate of DVT of lower extremity for high-risk in-patients was high,most of whom were asymptomatic and left-sided.High risk factors were bedrid time (30 day boundary),thrombin time and history of vascular surgery.It is necessary to strengthen prophylactic anticoagulation in these patients.