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首次孤立性浅静脉血栓形成后的血栓栓塞并发症:一项横断面回顾性研究。

Thromboembolic complications following a first isolated episode of superficial vein thrombosis: a cross-sectional retrospective study.

作者信息

Bell Lauren N, Berg Richard L, Schmelzer John R, Liang Hong, Mazza Joseph J, Kanth Rajan, Bray Christopher L, Zaldivar Calixto B, Yale Steven H

机构信息

Internal Medicine Residency Program, Departments of Graduate Medical Education and Internal Medicine, North Florida Regional Medical Center, 6500 Newberry Road, Gainesville, FL, 32614, USA.

Marshfield Clinic Research Foundation, Marshfield, WI, USA.

出版信息

J Thromb Thrombolysis. 2017 Jan;43(1):31-37. doi: 10.1007/s11239-016-1414-8.

Abstract

Superficial vein thrombosis (SVT) may be associated with complications such as venous thromboembolism (VTE) and recurrent SVT. The purpose of this study was to explore risk factors among patients with a first isolated episode of SVT (index SVT) involving upper and lower extremities and to estimate the prevalence of VTE complications within 1 year of index SVT. Retrospective chart review of electronic records at Marshfield Clinic in Wisconsin identified 381 subjects with a first isolated SVT diagnosis (male/female: 170/211; median age 59.4 years). Patients were stratified based on whether they did (n = 44; 11.5 %) or did not (n = 337; 88.5 %) experience VTE complications and whether they did (n = 25; 6.6 %) or did not (n = 356; 93.4 %) experience pulmonary embolism (PE) and/or deep vein thrombosis (DVT) within 1 year of index SVT. There were 49 complications among 44 patients; these included DVT (n = 18, 36.7 %), propagation of SVT (n = 18, 36.7 %), PE (n = 9, 18.4 %), new SVT at different location (n = 3, 6.1 %), and recurrent SVT (n = 1, 2.0 %). Univariate analysis of all VTE complications identified seven potential risk factors and similar analysis of PE/DVT complications identified eight potential risk factors, with six common risk factors identified in both analyses. Multivariate analysis identified indwelling venous catheter 30 days prior to SVT (p = 0.044), cancer history with treatment in the previous year (p = 0.001), and non-surgical trauma 7 days prior to SVT (p < 0.001) as independent risk factors for PE/DVT complications. Independent risk factors identified in the current study may convey greater risk for VTE complications, especially PE/DVT, following an initial isolated SVT episode.

摘要

浅静脉血栓形成(SVT)可能与静脉血栓栓塞(VTE)和复发性SVT等并发症相关。本研究的目的是探讨首次发生孤立性SVT(索引SVT)累及上肢和下肢的患者的危险因素,并估计索引SVT后1年内VTE并发症的发生率。对威斯康星州马什菲尔德诊所电子记录的回顾性图表审查确定了381例首次诊断为孤立性SVT的受试者(男/女:170/211;中位年龄59.4岁)。根据患者是否发生VTE并发症(n = 44;11.5%)或未发生(n = 337;88.5%)以及在索引SVT后1年内是否发生肺栓塞(PE)和/或深静脉血栓形成(DVT)(n = 25;6.6%)或未发生(n = 356;93.4%)进行分层。44例患者中有49例并发症;这些并发症包括DVT(n = 18,36.7%)、SVT扩展(n = 18,36.7%)、PE(n = 9,18.4%)、不同部位新发SVT(n = 3,6.1%)和复发性SVT(n = 1,2.0%)。对所有VTE并发症的单因素分析确定了7个潜在危险因素,对PE/DVT并发症的类似分析确定了8个潜在危险因素,两项分析中共有6个共同危险因素。多因素分析确定SVT前30天留置静脉导管(p = 0.044)、上一年有癌症病史且接受过治疗(p = 0.001)以及SVT前7天非手术创伤(p < 0.001)为PE/DVT并发症的独立危险因素。本研究中确定的独立危险因素可能表明,在首次发生孤立性SVT后,VTE并发症,尤其是PE/DVT的风险更高。

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