住院恶性肿瘤患者下肢深静脉血栓形成的筛查研究
The Deep Venous Thrombosis Screening Research in Malignant Tumor Patients in Hospital

DOI: 10.12677/ACM.2014.44010, PP. 53-57

Keywords: 住院患者，恶性肿瘤，下肢深静脉血栓形成，筛查
Inpatient, Malignant Tumor, LDVT, Screen

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Abstract:

目的：对住院恶性肿瘤患者进行下肢深静脉血栓形成(LDVT)的早期筛查研究。方法：使用Wells评分法结合血浆D-dimer检查对434例住院恶性肿瘤患者进行筛查。结果：234例住院恶性肿瘤患者为LDVT低风险(Wells评分 ≤ 1且血浆D-dimer检查为阴性)，未行彩色多普勒超声检查。其余200例患者为LDVT高风险(Wells评分 ≥ 2或血浆D-dimer检查为阳性)，行彩色多普勒超声检查，共确诊LDVT 22例(11%)。结论：使用Wells评分表结合D-dimer数值对住院恶性肿瘤患者进行LDVT早期筛查，可以有效评估住院恶性肿瘤病人发生LDVT的风险，有利于早期发现LDVT，并进行早期治疗及护理。
Objective: An early screening method of LDVT was used in malignant tumor patients in the hospital. Method: Wells score and blood plasma D-dimer were used together in 434 malignant tumor pa-tients to screen LDVT. Result: 234 malignant tumor patients didn’t receive the color doppler ul-trasound examination because they had the low risk of LDVT (Wells score ≤ 1 and D-dimer result was negtive). 200 malignant tumor patients received the color doppler ultrasound examination because they had the high risk of LDVT (Wells score ≥ 2 or D-dimer result was positive). 22 patients (11%) were diagnosed with LDVT. Conclusion: Using Wells score and D-dimer together can do the LDVT early screening in malignant patients. It can effectively evaluate the risk of LDVT in tumor patients and find the LDVT early as well as early treatment and nursing.

References

[1]	汪忠镐, 张建, 谷涌泉 (2004) 实用血管外科与血管介入治疗学. 人民军医出版社, 北京, 320-323.
[2]	Luzzatto, G. and Schafer, A.I. (1990) The prethrombotic state in cancer. Seminars in Oncology, 2, 147-159.
[3]	李会霞 (2005) 深静脉血栓形成病人延误就诊原因调查及护理对策. 护理学杂志, 24, 24-25.
[4]	雷朝晖, 刘建伟, 李伟涛 (2010) 恶性肿瘤并静脉血栓形成的诊治分析. 当代医学, 18, 94-95.
[5]	Jose, A.L. and Kearon, C. (2004) Deep venous thrombosis. Hematology, 2004, 439-456.
[6]	郭丹杰, 胡大一 (2008) 解读美国临床肿瘤学会癌症患者静脉血栓栓塞防治指南. 中国医药导刊, 1, 139-141.
[7]	李家增, 贺石材, 王鸿利 (1998) 血栓病学. 科学出版社, 北京, 243-244.
[8]	Pandey, A., Patni, N., Singh, M., et al. (2009) Assessment of risk and prophylaxis for deep vein thrombosis and pulmonary embolism in medically ill patients during their early days of hospital stay at a tertiary care center in a developing country. Journal of Vascular Health and Risk Management, 5, 643-648.
[9]	杨进刚 (2007) 美国医师学会静脉血栓栓塞性疾病诊疗指南解读. 心血管病学进展, 2, 193-194.
[10]	刘敬峰, 郭伟, 刘小平, 等 (2006) 血浆D-二聚体结合Wells临床评估量表对下肢深静脉血栓形成的诊断价值. 中国康复医学杂志, 21, 231-233.
[11]	Bemadi, E. (2004) Extended versus rapid analysis of the leg vein system a multicenter ultrasound study. Pathophysiology of Haemostasis and Thrombosis, 33, 314-318.
[12]	高宝安, 陈世雄, 杨俊 (2009) Wells评分法在静脉血栓栓塞症中的应用进展. 中国老年学杂志, 19, 2540-2543.
[13]	Baldwin, Z.K., Comerota, A.J., Schwartz, L.B., et al. (2004) Catheter-directed thrombolysis for deep venous thrombosis. Vascular and Endovascular Surgery, 38, 1-9.
[14]	Mccaffrey, R., Bishop, M., Adonis-Rizzo, M., et al. (2007) Development and testing of a DVT risk assess-ment tool: Providing evidence of validity and reliability. Worldviews on Evidence-Based Nursing, 4, 14-20.
[15]	Muller, G., Fritz, E. and Them, C. (2008) Translation of the “Autar Deep Vein Thrombosis Scale” to assess the risk of thrombosis. Pflege Zeitschrift, 61, 94-99.
[16]	Tamariz, L.J., Eng, J., Segal, J.B., et al. (2004) Usefulness of clinical prediction rules for the diagnosis of venous thromboembolism: A systematic review. The American Journal of Medicine, 117, 676-684.
[17]	Qaseem, A., Snow, V., Barry, P., et al. (2007) Current diagnosis of venous thromboembolism in priary care a clinical practice guideline from the American Academy of Family Physicians and the American College of Physicians. Annals of Internal Medicine, 146, 454-458.
[18]	Beyer, J. and Schellong, S. (2005) Deep vein thrombosis: Current diagnostic strategy. European Journal of Internal Medicine, 16, 238-246.

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