| 肺动脉栓塞合并急性下肢深静脉血栓形成的类型比例分析与解读 |
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| 引用本文： | 王颖,王孝高,宋涛,高涌,余朝文,聂中林,陈世远,卢冉.肺动脉栓塞合并急性下肢深静脉血栓形成的类型比例分析与解读[J].中华全科医学,2018,16(1):107-109. |
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| 作者姓名： | 王颖 王孝高 宋涛 高涌 余朝文 聂中林 陈世远 卢冉 |
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| 作者单位： | 1. 蚌埠医学院第一附属医院检验科, 安徽 蚌埠 233004; |
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| 基金项目： | 2015年度安徽省高等学校自然科学研究一般项目(KJ2015B025by) |
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| 摘 要： | 目的 分析肺动脉栓塞患者合并急性下肢深静脉血栓形成的临床症状及下肢静脉顺行造影表现,归纳各种类型下肢深静脉血栓形成并发肺动脉栓塞患者的临床特点,为临床诊疗提供指导。 方法 对2013年10月-2016年10月蚌埠医学院第一附属医院收住的45例经影像学确诊的肺动脉栓塞患者的下肢肿胀程度及下肢静脉顺行造影征象进行归纳、分析、总结。 结果 表现为下肢轻微度至中度肿胀者27例(60.0%),重度肿胀者10例(22.2%),无下肢肿胀者8例(17.8%)。症状为轻中度肿胀或无肿胀为35例,重度肿胀为10例,差异有统计学意义(χ2=9.59,P<0.05)。通过静脉顺行造影发现下肢周围型血栓,即腘静脉、股静脉及髂静脉通畅者9例(20.0%);股、腘静脉血栓形成,髂静脉通畅者19例(42.2%);髂静脉血栓形成者10例(22.2%);下腔静脉造影发现下腔静脉合并血栓形成者7例(15.6%),其中髂静脉通畅或未完全闭塞的患者为42例(93.3%)。 结论 下肢肿胀程度较轻的下肢深静脉血栓合并肺动脉栓塞的风险更大;下肢深静脉血栓形成患者的下肢深静脉造影类型中髂静脉通畅及合并下腔静脉血栓形成2种类型是发生肺动脉栓塞的高危因素。
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| 关 键 词： | 下肢深静脉血栓形成 肺动脉栓塞 静脉顺行造影检查 下肢肿胀 |
| 收稿时间： | 2017-02-27 |
Analysis and interpretation of the type of pulmonary embolism complicated with deep venous thrombosis of the lower extremities |
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| Affiliation: | Department of Laboratory, the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, China |
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| Abstract: | Objective To analyze the clinical symptoms and lower extremity anterograde venography imaging, to sum up the clinical features of pulmonary embolism complicated with deep venous thrombosis of the lower extremities, and to provide guidance for clinical diagnosis and treatment. Methods The clinical symptoms and anterograde lower extremity venography imaging of 43 cases who were diagnosed as pulmonary embolism at the first Affiliated Hospital of Bengbu Medical College from October, 2013 to October, 2016 were retrospectively analyzed. Results There were 27 patients with lower extremity mild swelling, 10 patients with lower extremity severe swelling, 8 patients without lower extremity swelling in clinical symptoms. The percentages were 60.0%, 28.9% and 11.1%, respectively. The patients of calf deep vein thrombosis with popliteal vein, femoral vein and iliac vein patency was 9 (20% of the total number); the patients of popliteal vein and femoral vein thrombosis with iliac vein patency was 19 (42.2% of the total number); the patients of iliac vein thrombosis was 10 (22.2% of the total number) by anterograde lower extremity anterograde venography imaging. The deep venous thrombosis of lower extremity with thrombosis of inferior vena cava is 7 (15.6% of the total number) by vena cava angiography. There are 45 cases with iliac vein patency or incomplete occlusion in all patients, most patients with mild to moderate swelling or no swelling. Conclusion The patients of lower limb swelling of the lower extremities deep vein thrombosis are more easily complicated by pulmonary embolism; iliac vein patency and thrombosis of inferior vena cava is very dangerous in the disease of venous thromboemlism through anterograde vein venography. |
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