Jiang Peng, Liu Jian-long, Jia Wei, Tian Xuan
Department of Vascular Surgery, Beijing Jishuitan Hospital, Beijing 100035, China.
Zhonghua Yi Xue Za Zhi. 2012 Dec 4;92(45):3224-6.
To explore the causative factors of lower limb deep vein thrombosis complicated with pulmonary artery embolism in orthopedics patients.
The clinical manifestations and causes of thrombosis defluxion of pulmonary artery embolism patients whose diagnosis were confirmed by computed tomography pulmonary angiography (CTPA) during May 2009-May 2012 were retrospectively analyzed.
Among 45 cases of CTPA-confirmed pulmonary artery embolism patients, 5 patients had no obvious clinical manifestation. The initial symptoms included chest stuffiness and dyspnea (n = 9) and cough (n = 8). And the major causes of thrombosis defluxion were early postoperative mobilization (n = 11), postoperative functional exercise (n = 9), rollover or defecation in bed (n = 7), sneezing (n = 2) and unknown causes (n = 14).
The patients with lower limb deep vein thrombosis have a high risk of thrombosis defluxion during unstable period. Despite adequate anticoagulation, early mobilization and functional exercise are likely to cause thrombosis defluxion and lead to pulmonary artery embolism.
探讨骨科患者下肢深静脉血栓形成合并肺动脉栓塞的致病因素。
回顾性分析2009年5月至2012年5月期间经计算机断层扫描肺动脉造影（CTPA）确诊的肺动脉栓塞患者血栓脱落的临床表现及原因。
在45例CTPA确诊的肺动脉栓塞患者中，5例无明显临床表现。初始症状包括胸闷、呼吸困难（9例）和咳嗽（8例）。血栓脱落的主要原因是术后早期活动（11例）、术后功能锻炼（9例）、床上翻身或排便（7例）、打喷嚏（2例）及原因不明（14例）。
下肢深静脉血栓形成患者在病情不稳定期有较高的血栓脱落风险。尽管进行了充分的抗凝治疗，但早期活动和功能锻炼仍可能导致血栓脱落并引发肺动脉栓塞。
