产后静脉血栓栓塞病症49例的临床影响因素分析.docVIP

产后静脉血栓栓塞病症49例的临床影响因素分析 　　doi：10.3969/j.issn.1007-614x.2014.21.33 　　摘 要 目的：探讨妇产科手术后发生静脉血栓栓塞病症的影响因素。方法：回顾性分析49例妇产科手术后发生静脉血栓栓塞病症的住院患者，以病例对照方法分别就其年龄特征、手术方式、前患病种等因素展开讨论。结果：发病时间多在术后1个月内，而妇科手术后发病时间要早于产科。发生血栓组中恶性肿瘤患者所占比重较高，在年龄差异上有统计学意义（P0.05）。结论：对比分析可知年龄在40～59岁恶性肿瘤患者发生VTE风险较大，而腹腔镜手术患者并未增加VTE风险，患者血浆高Fib是造成术后VTE高发的危险因素，妊娠及产褥期出现高Fib、血脂都容易诱发VTE风险。 　　关键词 妇产科手术 静脉血栓栓塞症（VTE） 手术并发症 危险因素 　　The analysis of the clinical influencing factors of 49 cases with postpartum venous thromboembolic disease 　　Chen Juan，Wang Baozhen，Li Zhimei 　　Department of Obstetrics and Gynecology，the Peoples Hospital of Huixian City，Henan 453600 　　Abstract Objective：To investigate the influencing factors on symptoms of venous thromboembolism after obstetrics and gynecology operation.Methods：A retrospective analysis of 49 cases with symptoms of venous thromboembolism occurred after the gynecology and obstetrics operation，and discussed the age characteristics，operation mode and the disease history respectively using case-control method.Results：The symptoms mostly onset within 1 months after operation，and the time of onset after the gynecologic operation was earlier than after the obstetrics operation.Patients with malignant tumor accounts for a high proportion in the thrombus group.The differences was statistically significant in age.Conclusion：The contrast analysis shows that，patients with malignant tumor had high risk of VTE at the age of 40～59 years old，and the risk of VTE did not increase in patients with laparoscopic operation.Patients with high plasma Fib was the factors on high incidence of VTE after surgery.High Fib or lipids in pregnancy and puerperal are easy to induce VTE. 　　Key words Obstetrics and gynecology operation；Venous thromboembolism；Complications of the operation；Risk factors 　　静脉血栓栓塞病症（VTE）多以手术后在深静脉内形成血液固体，阻塞回流而造成静脉壁炎性改变，而一旦血栓脱落又将诱发肺栓塞等疾病。妊娠期母体环境相对变化较大，如血液的稀释度、激素的变化、以及血脂的代谢紊乱等，都是诱发VTE病症的主要因素，如果不能及时有效预防，很容易留下后遗症，甚至因肺栓塞而猝死。 　　资料与方法 　　对象分组：①诊断标准满足深静脉血栓形成（DVT）或肺栓塞（PE）要求；②在DVT发病前