下肢深静脉血栓形成初治患者治疗后静脉通畅率的影响因素

发布时间：2018-05-31 23:24

本文选题：深静脉血栓形成 + 静脉通畅率　；参考：《四川大学学报(医学版)》2017年02期

【摘要】：目的分析下肢深静脉血栓形成(DVT)初治患者治疗后静脉通畅率改善的影响因素。方法收集2014年1月至2015年6月收治于南京医科大学附属南京医院的下肢DVT初治患者127例的临床资料。观察两组患者血液学指标、各项临床指标、相关病史、DVT分期(急性期、亚急性期、慢性期)、治疗方法(单纯药物、置管溶栓和/或器械取栓)、发病部位(单纯膝下、单纯膝上、混合型)。以静脉通畅率代表DVT治疗效果,回顾性分析多种因素对其治疗后静脉通畅率的影响。结果治疗后61例DVT患者静脉通畅率50%为劣效组,66例DVT患者静脉通畅率≥50%为优效组。劣效组男性30例(49.18%)、年龄(65.6±4.2)岁,优效组男性31例(46.97%)、年龄(63.7±3.9)岁。两组间性别比、年龄差异无统计学意义(P0.05)。随访截止至2015年12月31日。优效组患者中位随访时间为9.2月(1~21月),劣效组患者中位随访时间为6.4月(1~14月)。单因素分析结果显示:优效组患者的白细胞计数、血小板计数、血浆纤维蛋白原低于劣效组,两组比较,差异有统计学意义(P0.05);优效组与劣效组间患者在是否合并高血压、糖尿病、恶性肿瘤,DVT分期,治疗方法,发病部位这些方面,差异均有统计学意义(P0.05)。多因素logistic回归分析发现,白细胞计数、血浆纤维蛋白原、DVT分期、治疗方法、发病部位是下肢DVT治疗后静脉恢复通畅与否的独立影响因素(P0.05)。结论白细胞计数高、血浆纤维蛋白原数值高、DVT分期晚、仅采取单纯药物治疗、受累血管位于膝上时DVT治疗效果较差,不利于静脉通畅率的改善。
[Abstract]:Objective to analyze the factors influencing the improvement of venous patency in patients with DVT. Methods from January 2014 to June 2015, 127 patients with lower extremity DVT treated in Nanjing Hospital of Nanjing Medical University were collected. The hematologic indexes, clinical indexes, related history and DVT stages (acute, subacute, chronic) were observed in both groups. Treatment methods (simple drugs, catheter thrombolytic therapy and / or instrumentation for thrombolytic therapy), the site of the disease (simple knee, simple knee), and treatment methods (simple drug, catheter thrombolytic therapy and / or instrument thrombolysis) were observed. Mixed type. The effect of DVT was represented by the patency rate of vein, and the influence of many factors on the patency rate of vein after treatment was analyzed retrospectively. Results after treatment, the venous patency rate of 61 patients with DVT was 50%, that of 66 patients with DVT was better than 50%. There were 30 males (65.6 卤4.2) years old in the bad effect group and 46.97 years old (63.7 卤3.9) years old in the excellent effect group. There was no significant difference in sex ratio between the two groups (P 0.05). All patients were followed up until December 31, 2015. The median follow-up time of the patients in the excellent effect group was 9. 2 months from 1 to 21 months, and that in the poor group was 6. 4 months to 14 months. The results of univariate analysis showed that the white blood cell count, platelet count and plasma fibrinogen were lower in the superior group than in the inferior group, the difference was statistically significant (P 0.05). The difference of DVT stage, treatment method and location of diabetes mellitus and malignant tumor were statistically significant (P 0.05). Multivariate logistic regression analysis showed that the white blood cell count, the plasma fibrinogen stage, the treatment method and the location of the disease were the independent influencing factors of venous patency after DVT treatment in lower extremities (P 0.05). Conclusion the white blood cell count is high, the plasma fibrinogen value is high and the stage of DVT is late. Only drug treatment is used, and the effect of DVT is poor when the involved vessel is located on the knee, which is not conducive to the improvement of the patency rate of vein.
【作者单位】：南京医科大学附属南京医院介入科;南京医科大学附属妇产医院介入科;
【基金】：国家自然科学基金(No.81541061)资助
【分类号】：R543.6

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