围产期下肢深静脉血栓形成的临床特征及危险因素分析
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摘要
目的探讨围产期下肢深静脉血栓形成(DVT)的临床特征及危险因素。方法选择2016年1月—2017年12月就诊的18 742例围产期孕产妇的临床资料进行回顾性分析,观察一般资料与DVT相关性。结果本组发生DVT 152例(0. 81%)。35～42岁、静脉血栓史、双胎或多胎、妊娠期糖尿病、子痫前期、剖宫产、产后出血量≥1000 ml、卧床时间≥3 d是围产期DVT的独立危险因素(P <0. 05,P <0. 01)。结论围产期DVT是多种危险因素共同作用的结果,临床应注意进行针对性防治,以降低发生率。
Objective To investigate clinical characteristics and risk factors of deep vein thrombosis( DVT) of lower limbs in pregnant women during perinatal period. Methods Clinical data of 18 742 pregnant women during perinatal period during January 2016 and December 2017 was retrospectively analyzed. Correlation between general information of patients and pathogenesy of deep venous thrombosis of lower limbs was observed. Results Among the 18742 pregnant women,152( 0. 81%) pregnant women had DVT of lower limbs during perinatal period. At the age of 35-42 years old,history of venous thrombosis,twin or multiple pregnancy,gestational diabetes mellitus,preeclampsia,cesarean section,postpartum hemorrhage volume equal or more than 1000 mL and lying in bed time equal or more than 3d were independent risk factors for DVT during perinatal period( P < 0. 05,P < 0. 01). Conclusion Deep vein thrombosis of lower limbs in pregnant women during perinatal period is the result of a variety of risk factors,and therefore corresponding prevention and treatment should be given to reduce incidence rate.
Objective To investigate clinical characteristics and risk factors of deep vein thrombosis( DVT) of lower limbs in pregnant women during perinatal period. Methods Clinical data of 18 742 pregnant women during perinatal period during January 2016 and December 2017 was retrospectively analyzed. Correlation between general information of patients and pathogenesy of deep venous thrombosis of lower limbs was observed. Results Among the 18742 pregnant women,152( 0. 81%) pregnant women had DVT of lower limbs during perinatal period. At the age of 35-42 years old,history of venous thrombosis,twin or multiple pregnancy,gestational diabetes mellitus,preeclampsia,cesarean section,postpartum hemorrhage volume equal or more than 1000 mL and lying in bed time equal or more than 3d were independent risk factors for DVT during perinatal period( P < 0. 05,P < 0. 01). Conclusion Deep vein thrombosis of lower limbs in pregnant women during perinatal period is the result of a variety of risk factors,and therefore corresponding prevention and treatment should be given to reduce incidence rate.
引文
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[21]朱艳菊,杨晓峰,陈铎.早发型子痫前期患者血栓前状态分析及其干预措施[J].中国实用护理杂志,2012,28(4):46-47.
[22]敬晓琼,曹妍.剖宫产手术后预防深静脉血栓栓塞症的临床护理[J].西部医学,2010,22(4):761-762.
[23]张文华.产后大出血预防深静脉血栓的护理[J].临床医药文献杂志,2017,4(99):19501-19502.
[24]刘真,孙瑜.妊娠期及产褥期静脉血栓栓塞疾病诊治:2015英国皇家妇产科医师学会指南解读[J].中华围产医学杂志,2017,20(12):841-845.
[25]王晓燕,王秀.围生期孕产妇下肢深静脉血栓的临床特征、预后及影响因素分析[J].中国计划生育和妇产科,2016,8(9):28-31.
[26]张建东,卢冬喜,张伏生,等.长时间卧床住院患者下肢深静脉血栓形成的相关因素[J].中国全科医学,2012,15(10C):3466-3469.
[2]李嘉宏,曾仲衍,黄敏捷,等.单纯导管溶栓与吸栓联合导管溶栓治疗急性下肢深静脉血栓形成的疗效对比[J].血管与腔内血管外科杂志,2018,4(3):201-205.
[3]刘颖丽,吴跃芹,徐元春.产褥期下肢深静脉血栓17例临床分析[J].中国实验诊断学,2017,21(3):451-454.
[4]林敏,陈捷,黎慧南.围生期下肢静脉血栓57例临床分析[J].深圳中西医结合杂志,2016,26(10):111-112.
[5]孙灏,王瑜,魏俊强,等.下肢及骨盆骨折患者围手术期下肢静脉血栓形成的危险因素分析[J].现代医学,2017,45(7):910-915.
[6]吕颖,李渊.下肢深静脉血栓抗凝治疗的临床观察[J].血管与腔内血管外科杂志,2018,4(2):135-138.
[7]胡钦胜,沈彬,杨静,等.动态检测D-二聚体与血浆纤维蛋白原预测全髓置换术后下肢深静脉血栓的价值[J].中国骨与关节杂志,2013,2(3):133-137.
[8]曾祥永,周锡国,裴太蓉.骨科深静脉血栓形成因素及防治体会[J].中国中医急症,2011,20(6):928-930.
[9]徐冬,蔡淑萍,徐静薇,等.孕期及产褥早期妇女血浆D-二聚体水平的变化[J].中华妇产科杂志,2016,51(9):666-671.
[10]李少琴,武艳琳,周梅娟,等.早期体位干预对妊娠高血压疾病产妇产后下肢深静脉血栓形成的影响[J].现代预防医学,2012,39(19):5007-5008.
[11]孙梁.围生期体位管理对妊娠高血压孕产妇下肢静脉血栓形成的防治效果[J].中国民康医学,2015,27(22):86-87.
[12] Moigne E,Genty C,Meunier J,et al. Validation of the LEFt score,a newly proposed diagnostic tool for deep vein thrombosis in pregnant women[J]. Thromb Res,2014,134(3):664-667.
[13]龚云辉,胡蝶,周容.围生期深静脉血栓防治的循证评价[J].实用妇产科杂志,2009,25(3):150-151.
[14]王锋.围生期孕产妇发生下肢深静脉血栓危险因素的病例对照研究[J].解放军预防医学杂志,2017,35(8):922-924.
[15]滕晓慧,潘石蕾.孕妇年龄与妊娠高危因素及妊娠结局的关系[J].实用妇产科杂志,2017,33(9):692-696.
[16]党云,龙丽霞.妇产科术后深静脉血栓防治新进展[J].中国妇幼健康研究,2015,26(3):651-653.
[17]商福青,陈学青,张英剑,等.膝关节镜术后下肢静脉血栓形成的相关因素研究[J].中华骨与关节外科杂志,2015,8(5):390-395.
[18]陈红琢,蒋菊琴,陈可.深静脉血栓形成危险因素与干预[J].现代临床护理,2016,1(9):72-77.
[19]梁先慧.双胎孕妇产前及产后3天血浆D二聚体水平、抗凝血酶的变化及意义[J].现代诊断与治疗,2015,26(7):1620-1621.
[20]李一璞.妊娠期糖尿病孕妇血栓前状态标志物检测的分析[J].临床研究,2017,25(10):186-187.
[21]朱艳菊,杨晓峰,陈铎.早发型子痫前期患者血栓前状态分析及其干预措施[J].中国实用护理杂志,2012,28(4):46-47.
[22]敬晓琼,曹妍.剖宫产手术后预防深静脉血栓栓塞症的临床护理[J].西部医学,2010,22(4):761-762.
[23]张文华.产后大出血预防深静脉血栓的护理[J].临床医药文献杂志,2017,4(99):19501-19502.
[24]刘真,孙瑜.妊娠期及产褥期静脉血栓栓塞疾病诊治:2015英国皇家妇产科医师学会指南解读[J].中华围产医学杂志,2017,20(12):841-845.
[25]王晓燕,王秀.围生期孕产妇下肢深静脉血栓的临床特征、预后及影响因素分析[J].中国计划生育和妇产科,2016,8(9):28-31.
[26]张建东,卢冬喜,张伏生,等.长时间卧床住院患者下肢深静脉血栓形成的相关因素[J].中国全科医学,2012,15(10C):3466-3469.