下肢深静脉血栓形成在不同自然病程中的血流动力学观察：附203例报告

目的:分析不同自然病程下肢深静脉血栓血流动力学特点,为临床选择治疗方式提供依据。方法:回顾分析3年间收治的203例下肢深静脉血栓患者的临床资料;根据自然病程长短将患者分为急性、亚急性和慢性3组。所有患者入院时经彩色多普勒确诊并观察股、腘静脉流速、管径、凝血酶原时间和血浆纤维蛋白原含量等血流动力学参数。结果:除腘静脉管径组间无统计学差异外(P>0.05),股、腘静脉流速、股静脉管径、凝血酶原时间和血浆纤维蛋白原含量在各组间均有统计学差异(均P<0.05)。急性期股、腘静脉流速最慢,股静脉管径最大,血液也处于高凝状态;亚急性期和慢性期股静脉流速增加,管径缩小,高凝状态得到改善。结论:随自然病程的延续,下肢深静脉血栓的血流动力学呈现复杂多变的特点。

Hemodynamic observation of lower extremity deep venous thrombosis in different natural stages: a report of 203 cases

Objective: To analyze the hemodynamic features of lower extremity deep venous thrombosis(DVT) in different natural stages,so as to provide advices for treatment selection. Methods: The clinical data of 203 DVT patients admitted to our hospital during 3 years were retrospectively analyzed.The patients were divided into acute,subacute and chronic group based on their natural stages.For all the patients,the flow velocities,diameters of femoral and popliteal vein were measured by ultrasonography,and the hemodynamic parameters such as prothrombin time and blood fibrinogen were detected at the time of hospital admission. Results: Except for the popliteal vein diameter that showed no statistical difference among the 3 groups,other parameters such as femoral vein and popliteal vein flow velocity,femoral vein diameter,prothrombin time and blood fibrinogen were statistically different among the 3 groups(all P<0.05).In acute stage,the femoral and popliteal vein showed the slowest flow velocity,while the femoral vein showed the widest diameter and the blood showed a hypercoagulable state.In subacute and chronic stage,the femoral vein flow velocity increased,the vein diameter was reduced and the hypercoagulabe state was lessened. Conclusion: The hemodynamic state of lower extremity DVT presents a complex and changeable feature as its natural stages develop.