孕产妇发生下肢深静脉血栓的相关影响因素(1)
[摘要] 目的 探討影响孕产妇发生下肢深静脉血栓的相关因素及诊疗方案。 方法 选择2016年6～12月在河北省唐山市妇幼保健院产科和唐山市工人医院血管外科就诊的孕产妇作为研究对象，其中73例下肢深静脉血栓孕产妇作为研究组，并随机选取73例非下肢深静脉血栓孕产妇作为对照组。探讨下肢深静脉血栓的发生率、危险因素构成比、诊断和治疗方案、治疗预后。 结果 6425例孕产妇共计发生下肢深静脉血栓73例，发生率为1.14%。多因素Logistic回归分析结果显示，年龄、体重指数、产褥期卧床时间、剖宫产、产后出血、妊娠期高血压、妊娠期糖尿病是孕产妇下肢深静脉血栓发生危险因素(P < 0.05)。11例患者单纯抗凝治疗，患者下肢肿胀等症状较前缓解，其中8例患者发生深静脉血栓形成后综合征。溶栓治疗的62例患者大腿周径、小腿周径、静脉通畅评分均较溶栓治疗前显著改善(P < 0.01)。随访发现患者下肢深静脉血栓均溶解，46例静脉管腔恢复通畅，5例存在轻度充盈缺损，其中5例发生深静脉血栓形成后综合征。 结论 孕产妇是下肢深静脉血栓的高危人群，对孕产妇下肢深静脉血栓的危险因素进行干预有利于降低下肢深静脉血栓的发生，合理的治疗方案可提高治疗效果，确保母儿安全。
[关键词] 孕产妇;下肢深静脉血栓;影响因素;诊断方法;治疗方案
[中图分类号] R654.4 [文献标识码] A [文章编号] 1673-7210(2018)12(c)-0075-04
[Abstract] Objective To explore the related factors and diagnosis and treatment scheme of lower extremity deep venous thrombosis in pregnant women. Methods From June to December 2016， pregnant women in Department of Obstetrics of Tangshan City Maternity and Child Care Hospital and Department of Vascular Surgery of Tangshan Gongren Hospital in Heibei Province were selected as research subjects， 73 pregnant women with deep venous thrombosis of lower extremities were enrolled in study group， and 73 pregnant women with non deep venous thrombosis were selected as control group. The incidence of deep venous thrombosis， constituent ratio of risk factors， diagnosis and treatment plan， and the prognosis of treatment were discussed. Results There were 73 cases of deep venous thrombosis occurred in 6425 pregnant women， and the incidence rate was 1.14%. Multivariate Logistic regression analysis showed that age， body mass index， puerperal bed rest time， cesarean section， postpartum hemorrhage， gestational hypertension and gestational diabetes were risk factors for the occurrence of deep vein thrombosis in maternal lower limbs (P < 0.05). The symptoms such as swelling of the lower extremities were relieved， and 8 of them developed deep vein thrombosis syndrome. After thrombolytic therapy， the thigh diameter， leg circumference and venous patency score were significantly improved in 62 patients， compared with before thrombolytic therapy (P < 0.01). During the follow-up， patients with deep venous thrombosis of the lower extremities were dissolved， 46 cases of venous lumen recovered unobstructed and 5 cases had mild filling defect， of which 5 cases had deep venous thrombosis syndrome. Conclusion The pregnant women are high risk group of deep venous thrombosis of lower extremity. The intervention on the risk factors of deep venous thrombosis of the lower limbs of pregnant and parturient is beneficial to reduce the occurrence of deep vein thrombosis of lower extremity. The reasonable treatment plan can improve the effect of treatment and ensure the safety of mother and child., 百拇医药(张春梅 杨涛 安娜 孙丽君 武军)
[关键词] 孕产妇;下肢深静脉血栓;影响因素;诊断方法;治疗方案
[中图分类号] R654.4 [文献标识码] A [文章编号] 1673-7210(2018)12(c)-0075-04
[Abstract] Objective To explore the related factors and diagnosis and treatment scheme of lower extremity deep venous thrombosis in pregnant women. Methods From June to December 2016， pregnant women in Department of Obstetrics of Tangshan City Maternity and Child Care Hospital and Department of Vascular Surgery of Tangshan Gongren Hospital in Heibei Province were selected as research subjects， 73 pregnant women with deep venous thrombosis of lower extremities were enrolled in study group， and 73 pregnant women with non deep venous thrombosis were selected as control group. The incidence of deep venous thrombosis， constituent ratio of risk factors， diagnosis and treatment plan， and the prognosis of treatment were discussed. Results There were 73 cases of deep venous thrombosis occurred in 6425 pregnant women， and the incidence rate was 1.14%. Multivariate Logistic regression analysis showed that age， body mass index， puerperal bed rest time， cesarean section， postpartum hemorrhage， gestational hypertension and gestational diabetes were risk factors for the occurrence of deep vein thrombosis in maternal lower limbs (P < 0.05). The symptoms such as swelling of the lower extremities were relieved， and 8 of them developed deep vein thrombosis syndrome. After thrombolytic therapy， the thigh diameter， leg circumference and venous patency score were significantly improved in 62 patients， compared with before thrombolytic therapy (P < 0.01). During the follow-up， patients with deep venous thrombosis of the lower extremities were dissolved， 46 cases of venous lumen recovered unobstructed and 5 cases had mild filling defect， of which 5 cases had deep venous thrombosis syndrome. Conclusion The pregnant women are high risk group of deep venous thrombosis of lower extremity. The intervention on the risk factors of deep venous thrombosis of the lower limbs of pregnant and parturient is beneficial to reduce the occurrence of deep vein thrombosis of lower extremity. The reasonable treatment plan can improve the effect of treatment and ensure the safety of mother and child., 百拇医药(张春梅 杨涛 安娜 孙丽君 武军)