妇科盆腔手术后下肢深静脉血栓形成的回顾分析和前瞻性研究Retrospective analysis and prospective studies of lower extremity deepvenousthrombosis after gynecological pelvic surgeries
朱新贤;欧阳一芹;韩巍巍;童晓文;赵志青;李怀芳;
摘要(Abstract)：
目的:探讨妇科盆腔手术后并发下肢深静脉血栓(LEDVT)形成的潜在危险因素及预防措施。方法:回顾分析2009年1月至2011年12月于同济大学附属同济医院住院并行盆腔手术的4319例妇科患者的临床资料,其中术后发生LEDVT者358例,分析可能的危险因素并总结治疗经验。对2012年1至12月于我院拟行盆腔手术的1561例患者按潜在的危险因素预防治疗,分析其预防及治疗效果。结果:回顾性研究中,盆腔手术后LEDVT的发病率为8.3%;高龄、高脂血症、手术时程>5h以及术后卧床时间>7d可能是盆腔手术后发生LEDVT的危险因素。对拟行盆腔手术并伴有高危因素的117例患者进行预防治疗,7例术后发生LEDVT,发生率为0.45%。7例术后发生LEDVT者采取一般治疗与药物治疗,其中6例无效,需行手术治疗。发生LEDVT患者的术后卧床时间显著长于无发生LEDVT者。回顾分析中确诊PE 32例,前瞻性研究中均无PE发生。结论:血液呈高凝状态、血流缓慢及血管壁的损伤是血栓形成的主要因素,对有LEDVT形成的高危因素的患者采取预防性治疗可有效减少其发生并取得理想的治疗效果。
关键词(KeyWords)： 妇科盆腔手术;下肢深静脉血栓形成;危险因素;预防
基金项目(Foundation):
作者(Authors): 朱新贤;欧阳一芹;韩巍巍;童晓文;赵志青;李怀芳;
DOI: 10.13283/j.cnki.xdfckjz.2014.01.028
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