Cameron E W, Sachdev D, Gishen P, Martin J F
Department of Medicine, King's College School of Medicine and Dentistry, London, UK.
Eur J Clin Invest. 1991 Oct;21(5):548-50. doi: 10.1111/j.1365-2362.1991.tb01408.x.
Pulmonary embolism secondary to deep vein thrombosis is a frequent cause of death in stroke patients. In a multicentre study of deep vein thrombosis prophylaxis, 112 patients with cerebral infarction and leg paresis were given aspirin 300 mg three times a day (t.d.s.) alone or with dipyridamole 100 mg t.d.s. To screen for deep vein thrombosis liquid crystal thermography of the legs was performed daily for 15 days on all patients. Those patients with positive thermography underwent immediate X-ray venography of the appropriate limb as the definitive investigation for venous thrombosis. Twenty-two patients had positive thermograms, of whom 16 had confirmed deep vein thrombosis as demonstrated by X-ray venography. Only 8 of the 22 had clinical signs of deep vein thrombosis and 2 of those had a negative venogram. Of the 14 patients with positive thermography but negative clinical signs 10 had positive venograms. Difference in the incidence of deep vein thrombosis in the two treatment groups was not demonstrated. It is concluded that occult deep venous thrombosis is common after ischaemic stroke and it can occur without clinical signs. Liquid crystal thermography is a simple, rapid and cheap screening test that will allow the detection of clinically unrecognized thrombosis.
继发于深静脉血栓形成的肺栓塞是中风患者常见的死亡原因。在一项关于深静脉血栓形成预防的多中心研究中，112例脑梗死伴腿部麻痹患者单独服用阿司匹林300毫克，每日三次（t.d.s.），或同时服用双嘧达莫100毫克，每日三次（t.d.s.）。为筛查深静脉血栓形成，对所有患者连续15天每天进行腿部液晶热成像检查。热成像阳性的患者立即对相应肢体进行X线静脉造影，作为静脉血栓形成的确诊检查。22例患者热成像阳性，其中16例经X线静脉造影证实有深静脉血栓形成。22例中只有8例有深静脉血栓形成的临床体征，其中2例静脉造影阴性。14例热成像阳性但无临床体征的患者中，10例静脉造影阳性。两个治疗组深静脉血栓形成的发生率无差异。得出的结论是，缺血性中风后隐匿性深静脉血栓形成很常见，且可无临床体征。液晶热成像是一种简单、快速且廉价的筛查试验，可检测出临床上未被识别的血栓形成。
