苗旺;张书语;郭俊爽;申楠楠;任志平;宋丹丹;臧秋玲;崔璨;滕军放;

• 1:郑州大学第一附属医院

摘要(Abstract)：

目的回顾性分析神经重症患者血栓(Deep vein thrombosis,DVT)形成的相关因素,为寻找早期、敏感的DVT预测和干预指标提供参考。方法选取2018-07―2019-12郑州大学第一附属医院行四肢深静脉彩色超声检查的2 031患者为研究对象,统计其DVT的发生率。并将生化、血栓弹力图(Thromboelastography,TEG)及下肢深静脉彩超结果均齐全的284例患者分为有血栓组和无血栓组进行对比分析。结果 2 031患者中DVT 516例,发生率25.4%。资料齐全的284例患者中,DVT 120例,无DVT 164例;其中无症状DVT 109例(90.83%),包括肌间DVT 103例,肌间合并非肌间3例,非肌间DVT3例;症状性DVT 11例(9.17%)。与无DVT组相比,DVT组患者年龄较大(63.28±12.20 vs 57.77±15.62);TEG-R值减小[4.30(3.80,5.60) vs 4.80(4.10,5.80)];TEG-K值减小[1.50(1.20,1.80) vs 1.60(1.30,2.20)];部分活化凝血酶时间(Activated partial thrombin time,APTT)缩短[28.05(26.03,30.8) vs 29.10(27.00,31.58)];D-二聚体增高[0.76(0.35,1.85) vs 0.46(0.18,0.90)],纤维蛋白降解产物(Fibrinogen degradation products,FDP)升高[6.31(2.79,12.77) vs 3.98(1.87,8.49)];以上差异均具有统计学意义(P<0.05)。结论神经重症急性期约1/4患者将发生DVT,且以无症状性的下肢肌间静脉血栓为主;与DVT相关因素为患者年龄偏大,凝血因子功能增强,纤维蛋白原功能增强,FDP和D-二聚体升高。

关键词(KeyWords)： 神经重症;深静脉血栓;血栓弹力图;纤维蛋白降解产物;D-二聚体

Abstract:

Keywords:

基金项目(Foundation): 河南省高等学校重点科研项目(编号:17A320067);; 河南省医学科技攻关计划联合共建项目(编号:LHGJ20190087)

作者(Authors): 苗旺;张书语;郭俊爽;申楠楠;任志平;宋丹丹;臧秋玲;崔璨;滕军放;

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