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中国人群中的静脉血栓栓塞症——香港一家地区医院的经验

Venous thromboembolism in the Chinese population--experience in a regional hospital in Hong Kong.

作者信息

Liu H S Y, Kho B C S, Chan J C W, Cheung F M F, Lau K Y, Choi F P T, Wu W C, Yau T K

机构信息

Department of Medicine, Pamela Youde Nethersole Eastern Hospital, 3 Lok Man Road, Chai Wan, Hong Kong.

出版信息

Hong Kong Med J. 2002 Dec;8(6):400-5.

Abstract

OBJECTIVE

To estimate the incidence and determine the characteristic features of venous thromboembolism in the Hong Kong Chinese population.

DESIGN

Retrospective study.

SETTING

Regional hospital, Hong Kong.

SUBJECTS AND METHODS

Data were collected during a period of four years (1997-2000). Patients with duplex doppler ultrasonography or venography-documented venous thromboembolism and new episodes of deep vein thrombosis were identified from Department of Diagnostic Radiology records. Patients with high-probability ventilation-perfusion scans were identified from Department of Nuclear Medicine records and these scans were taken as evidence of pulmonary embolism. Patients with intermediate-probability ventilation-perfusion scans, with pulmonary embolism documented by either pulmonary angiography or spiral computed tomography scan, were also included in the study. Patients with autopsy-verified fatal pulmonary embolism were identified from Department of Pathology records. Patients with deep vein thrombosis at other sites were sought from patient discharge diagnostic coding data. Medical records were reviewed for patient characteristics and conditions associated with the development of venous thromboembolism.

RESULTS

Three hundred and seventy-six Chinese patients had venous thromboembolism during the study period. Of these, 352 had peripheral deep vein thrombosis, five had deep vein thrombosis at other sites (cerebral sinus and portal vein thrombosis), 40 had pulmonary embolism (26 had concomitant deep vein thrombosis), and six had fatal pulmonary embolism shown at autopsy.

CONCLUSION

The calculated annual incidence of venous thromboembolism in Hong Kong Chinese people was estimated at 16.6 events per 100,000 population, which is lower than incidence rates reported in Caucasians. The four conditions most commonly associated with venous thromboembolism were medical illness, malignancy, orthopaedic surgery, and intravenous drug use. Conditions associated with venous thromboembolism in patients younger than 45 years included intravenous drug use, thrombophilia, pregnancy, and the use of oral contraceptives.

摘要

目的

评估香港华人静脉血栓栓塞症的发病率,并确定其特征。

设计

回顾性研究。

地点

香港地区医院。

研究对象与方法

收集了四年(1997 - 2000年)期间的数据。从诊断放射科记录中识别出经双功多普勒超声检查或静脉造影证实有静脉血栓栓塞症以及新发深静脉血栓形成的患者。从核医学科记录中识别出通气-灌注扫描为高概率的患者,这些扫描被视为肺栓塞的证据。通气-灌注扫描为中等概率且经肺血管造影或螺旋计算机断层扫描证实有肺栓塞的患者也纳入研究。从病理科记录中识别出经尸检证实为致命性肺栓塞的患者。从患者出院诊断编码数据中查找其他部位深静脉血栓形成的患者。查阅病历以了解患者特征以及与静脉血栓栓塞症发生相关的情况。

结果

在研究期间,376名中国患者患有静脉血栓栓塞症。其中,352人患有外周深静脉血栓形成,5人在其他部位有深静脉血栓形成(脑窦和门静脉血栓形成),40人患有肺栓塞(26人同时伴有深静脉血栓形成),6人经尸检显示为致命性肺栓塞。

结论

香港华人静脉血栓栓塞症的计算年发病率估计为每10万人中有16.6例,低于白种人报告的发病率。与静脉血栓栓塞症最常相关的四种情况是内科疾病、恶性肿瘤、骨科手术和静脉药物使用。45岁以下患者中与静脉血栓栓塞症相关的情况包括静脉药物使用、血栓形成倾向、妊娠和口服避孕药的使用。

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