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肝硬化合并静脉血栓栓塞症的临床诊治

  • 摘要: 目的:探讨肝硬化合并静脉血栓栓塞症(venous thromboembolism, VTE)的临床特征及诊治要点。方法:回顾分析复旦大学附属中山医院2004年1月至2015年12月期间收住入院的23例VTE合并肝硬化患者的临床特征及治疗预后。结果:观察期内 VTE合并肝硬化患者的发生率为0.8%。23例患者中男性16例,女性7例,年龄43~84岁,平均(55.7±10.1)岁。肝硬化A级患者(n=9)血清蛋白及血红蛋白含量高于肝硬化B级、C级患者(n=14),差异有统计学意义(P<0.05);A级患者凝血功能和血肌酐水平优于B级、C级患者,其D二聚体水平及血小板含量略低于B级、C级患者,但两组间各项指标差异无统计学意义。73.9%的患者也有恶性肿瘤病史。18例患者接受低分子肝素治疗;5例患者未接受抗凝治疗,其中3例死亡。结论:肝硬化患者也有静脉血栓形成风险,需要早期诊断,及时治疗。

     

    Abstract: Objective:To explore the clinical features and key points in treatment and diagnosis of venous thromboembolism (VTE) combined cirrhosis. Methods:Clinical data of 23 patients with venous thromboembolism combined cirrhosis were analyzed retrospectively. Results:The incidence rate of VTE combined cirrhosis was 0.8%. Sixteen males and seven females were enrolled in this study, aged from 43 to 84 years old with an average age of (55.7±10.1) years old. The levels of blood albumin and hemoglobin of A level liver cirrhosis patients (n=9) were obviously higher than B level and C level liver cirrhosis patients (n=14, P<0.05). The blood coagulation and serum creatinine in A level patients were better than B level and C level patients, and the D dimer and blood platelet was slightly lower than B level and C level patients, but no statistical significance was found between two groups. There were 73.9% patients had malignant tumor history. Eighteen patients received low molecular weight heparin for treatment. Five patients did not receive any anticoagulation therapy, and three of them died during hospitalization. Conclusions:The physicians should pay attention to the risk of the cirrhotic patients with VTE developing, and its need for early diagnosis and timely treatment.

     

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