下肢深静脉血栓形成及其并发症在法医学鉴定的研究

发布时间：2018-11-01 16:45

【摘要】：目的：1.探讨下肢深静脉血栓形成的病因及诊断方法,为法医学鉴定提供合理依据。 2.探讨下肢深静脉血栓的并发症及预后,为法医学伤残评定及损害赔偿提供建议。对象和方法：选择2006年2月至2009年10月郑大五附院收治的125例下肢深静脉血栓患者的临床资料进行分析。结果：下肢深静脉血栓形成(DVT)可发生在青少年到老年之间的各个年龄段,以50-60岁为发病年龄高峰。患者症状不一,与血栓形成部位、年龄、体质等因素有关。左侧肢体较右侧肢体病变常见,且以周围型病变居多。自发性DVT以左下肢多见,有危险因素的DVT两侧肢体发病率无明显差别。超声检查可准确诊断下肢近端DVT。发病一周内进行治疗的患者,其疗效优于发病一周后接受治疗的患者；抗凝联合溶栓治疗较单纯抗凝治疗临床症状缓解快,远期疗效无差异。DVT病变早期给予抗凝溶栓治疗联合长期华法林抗凝治疗可降低肺栓塞和深静脉血栓形成后综合症的发生结论：创伤、手术、长期卧床等是DVT的主要获得性病因,以彩超为主的影像学检查是DVT的确诊方法。肺栓塞(PE)是DVT最严重的并发症,死亡率高；深静脉血栓形成后综合征(PTS)是急性下肢深静脉血栓形成最严重的远期并发症,使肢体处于病废状态,在法医学鉴定中应充分考虑以上几方面的表现及联系。
[Abstract]:Purpose 1. To explore the etiology and diagnostic methods of deep venous thrombosis of lower extremity and to provide reasonable basis for forensic identification. 2. To investigate the complications and prognosis of deep venous thrombosis of lower extremity and provide advice for forensic evaluation and compensation for injury. Objects and methods: 125 patients with deep venous thrombosis of lower extremity were selected from Feb 2006 to Oct 2009. Results: deep vein thrombosis (DVT) of lower extremity occurred in all ages from adolescent to old, with 50-60 years old as the peak age of onset. The symptoms of the patients are different, and thrombus formation site, age, physique and other factors. The lesion of left limb is more common than that of right limb, and peripheral lesions are more common. Spontaneous DVT was more common in left lower extremities, but there was no significant difference in the incidence of DVT with risk factors. Ultrasonic examination can accurately diagnose lower extremity proximal DVT. The curative effect of the patients who had been treated within one week after the onset of the disease was better than that of the patients who received the treatment one week after the onset of the disease. Anticoagulant therapy combined with thrombolytic therapy can relieve clinical symptoms faster than anticoagulant therapy alone. Early anticoagulant thrombolytic therapy combined with warfarin anticoagulant therapy can reduce the incidence of pulmonary embolism and deep venous thrombosis syndrome. Long-term bed rest is the main acquired cause of DVT, and color Doppler imaging is the diagnostic method of DVT. Pulmonary embolism (PE) is the most serious complication of DVT with high mortality. Deep venous thrombosis syndrome (PTS) is the most serious long-term complication of acute deep venous thrombosis of lower extremity, which causes the limb to be in a state of disservice.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：D919.1

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