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下肢深靜脈血栓發(fā)生無癥狀性肺栓塞的相關(guān)危險因素

發(fā)布時間:2018-06-24 來源: 歷史回眸 點擊:


  [摘要] 目的 分析下肢深靜脈血栓(DVT)患者發(fā)生無癥狀性肺栓塞(PE)的危險因素。方法 方便選取該院收治的150例DVT患者,納入時間為2014年6月—2017年6月。依據(jù)肺動脈造影(CTPA)結(jié)果將其分為兩組:無癥狀PE組47例,癥狀性PE組103例。收集患者的資料病情,通過對比分析明確無癥狀性PE的危險因素。結(jié)果 無癥狀性PE組DVT以右側(cè)患肢(59.6%)、中央型(63.8%)、有DVT病史(78.7%)、有心臟疾。68.1%)為主;癥狀性PE組DVT以左側(cè)患肢(82.5%)、周圍型(65.0%)、無DVT病史(66.0%)、無心臟疾病(72.8%)為主,差異有統(tǒng)計學(xué)意義(P<0.05)。Logistic回歸分析可知右側(cè)患肢(OR=3.688,P=0.040)、中央型DVT(OR=0.164,P=0.001)、有DVT病史(OR=0.182,P=0.012)、有心臟疾病(OR=4.050,P=0.043)和無癥狀性PE的發(fā)生密切相關(guān),視為危險因素。結(jié)論 DVT患者發(fā)生無癥狀性PE的概率高,其中右側(cè)患肢、中央型DVT、有DVT病史、合并心臟疾病是危險因素,此類患者應(yīng)該盡早診斷并干預(yù)處理。
  [關(guān)鍵詞] DVT;無癥狀性PE;癥狀性PE;危險因素
  [中圖分類號] R563.5 [文獻(xiàn)標(biāo)識碼] A [文章編號] 1674-0742(2018)01(c)-0160-03
  [Abstract] Objective This paper tries to analyze the risk factors of asymptomatic pulmonary embolism in patients with deep venous thrombosis. Methods 150 cases of DVT patients in this hospital from June 2014 to June 2017 were convenient selected, according to the results of computed tomography pulmonary arteriography, they were divided into two groups: asymptomatic PE group with 47 cases, symptomatic PE group of 103 cases. The data of patients were collected and the risk factors of asymptomatic PE were determined by comparative analysis. Results Asymptomatic PE group DVT with right limb(59.6%), central type (63.8%), a history of DVT (78.7%), heart disease (68.1%);PE group DVT with symptomatic left limb (82.5%), peripheral type(65.0%), no history of DVT (66.0%), no history of heart disease (72.8%), with significant difference(P<0.05). Logistic regression analysis showed that right limb (OR=3.688,P=0.040), central DVT(OR=0.164,P=0.001), DVT history(OR=0.182,P=0.012), heart disease(OR=4.050,P=0.043) and asymptomatic PE were closely related, considered as risk factors. Conclusion The probability of asymptomatic PE in patients with DVT is high, in which the right side of the affected limb, central DVT, DVT history, and heart disease are risk factors, such patients should be diagnosed and treated as soon as possible.
  [Key words] DVT; Asymptomatic PE; Symptomatic PE; Risk factors
  DVT是臨床上常見的血管性疾病,主要發(fā)病部位是雙下肢,數(shù)據(jù)調(diào)查顯示發(fā)生率約為5%,隨著患者年齡增高,發(fā)病幾率也在提高[1]。針對DVT的研究顯示,發(fā)病機(jī)制在于血流緩慢、血液高凝狀態(tài)、靜脈壁損傷,且影響因素較多。其中,患者治療期間容易出現(xiàn)并發(fā)癥,以無癥狀性PE為例,具有發(fā)病隱匿性,增加了死亡風(fēng)險[2]。明確無癥狀性PE的危險因素,早期實施針對性的干預(yù)措施,能改善患者預(yù)后;诖耍撐膶υ撛2014年6月—2017年6月期間的150例患者進(jìn)行研究,探討了無癥狀性PE的危險因素,報道如下。
  1 資料與方法
  1.1 一般資料
  方便選取該院收治的下肢深靜脈血栓病例150例,無癥狀PE組47例,包括男性25例、女性22例;年齡位于23~84歲,平均(61.3±7.5)歲;BMI在19~30 kg/m2之間,平均(24.4±3.2)kg/m2;DVT患肢:左側(cè)19例、右側(cè)28例。癥狀性PE組103例,包括男性55例、女性48例;年齡位于24~85歲,平均(62.5±7.7)歲;BMI在18~31 kg/m2之間,平均(25.0±3.5)kg/m2;DVT患肢:左側(cè)85例、右側(cè)18例。兩組一般資料差異無統(tǒng)計學(xué)意義(P>0.05)。1.2 納入和排除標(biāo)準(zhǔn)

相關(guān)熱詞搜索:下肢 危險 因素 發(fā)生 無癥狀

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