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[不同基础疾病住院患者深静脉血栓形成的对比研究]

[Comparative study on deep venous thrombosis onset in hospitalized patients with different underlying diseases].

作者信息

Sun M L, Wang X H, Huang J, Wang J, Wang Y

机构信息

Department of Respiratory Medicine, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing 100038, China.

出版信息

Zhonghua Nei Ke Za Zhi. 2018 Jun 1;57(6):429-434. doi: 10.3760/cma.j.issn.0578-1426.2018.06.007.

Abstract

To improve the understanding of deep venous thrombosis (DVT), the present study was conducted to investigate the difference of DVT onset in hospitalized patients with different underlying diseases. This is a single-center retrospective study from Beijing Shijitan Hospital. Clinical data from hospital onset DVT patients from 2007 to 2016 were collected. DVT was confirmed with compression ultrasonography (CUS), color Doppler flow imaging (CDFI), CT venography (CTV), magnetic resonance venography (MRV), lower extremities radionuclide venography(RDV) or conventional venography (CV). The risk factors of DVT in hospital were analyzed with a Chi-square analysis. A total of 5 063 patients (1.65%) with DVT involving 5 024 veins were identified from 305 922 inpatients admitted without DVT during ten years. Among DVT patients, 2 752 were males (54.36%) and 2 311 were females (45.64%) with age of (74.1±15.9) years (range from 1 to 103 years). Patients with DVT were elder and longer inhospital than those without DVT ( 0.001). Patients with respiratory diseases had higher incidence of DVT (6.83%, 5.498, 95% 5.151-5.868) than those with other system diseases, in which patients with respiratory failure had the highest incidence of DVT (9.53%, 95% 6.912-8.018) among all patients. The risks of having DVT were higher in patients with serious internal medicine diseases than those in patients with trauma, or cataclasis/operations, or invasive manipulations. Among all DVT patients, 71.54% of them were with inflammation diseases, 55.56% were with hypertension and 54.93% were with structural heart disease. DVT often occurred in inferior extremities (83.78%, 4 360/5 063) in patients irrespective of underlying diseases. There is an association between underlying diseases of hospitalized patients and the development of DVT. Patients with internal medicine diseases had higher risk to develop DVT than those with trauma or cataclasis/operations or invasive manipulations. To prevent the development of DVT, its screening should be emphasized in patients with serious internal diseases.

摘要

为提高对深静脉血栓形成(DVT)的认识,本研究旨在调查不同基础疾病住院患者DVT发病情况的差异。这是一项来自北京世纪坛医院的单中心回顾性研究。收集了2007年至2016年医院内新发DVT患者的临床资料。DVT通过压迫超声检查(CUS)、彩色多普勒血流成像(CDFI)、CT静脉造影(CTV)、磁共振静脉造影(MRV)、下肢放射性核素静脉造影(RDV)或传统静脉造影(CV)确诊。采用卡方分析对医院内DVT的危险因素进行分析。在十年间收治的305922例无DVT的住院患者中,共识别出5063例(1.65%)发生DVT的患者,累及5024条静脉。在DVT患者中,男性2752例(54.36%),女性2311例(45.64%),年龄为(74.1±15.9)岁(范围为1至103岁)。发生DVT的患者比未发生DVT的患者年龄更大且住院时间更长(P<0.001)。呼吸系统疾病患者的DVT发生率(6.83%,χ²=5.498, 95%CI为5.151-5.868)高于其他系统疾病患者,其中呼吸衰竭患者的DVT发生率在所有患者中最高(9.53%,95%CI为6.912-8.018)。患有严重内科疾病的患者发生DVT的风险高于创伤、骨折/手术或侵入性操作患者。在所有DVT患者中,71.54%患有炎症性疾病, 55.56%患有高血压,54.93%患有结构性心脏病。无论基础疾病如何,DVT在患者下肢发生率较高(83.78%,4360/5063)。住院患者的基础疾病与DVT的发生有关联。患有内科疾病的患者发生DVT的风险高于创伤、骨折/手术或侵入性操作患者。为预防DVT的发生,应重视对患有严重内科疾病患者的筛查。

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