| 摘要: |
| [摘要]目的：探讨儿童静脉血栓的临床特征及危险因素，为儿童静脉血栓的预防、早期发现及治疗提供参考。方法：收集重庆医科大学附属儿童医院2013年1月至2017年6月确诊的126例静脉血栓患儿的临床资料，分析其基础疾病、年龄、性别、临床表现、治疗及预后情况，评估血栓形成的危险因素。结果：静脉血栓的总体发生率为0.41‰，发生率呈逐年上升趋势；2~<3岁年龄组患儿比例最大，为21.43%；患儿来源科室主要有血液科（主要为ALL）、肾脏免疫科、重症监护室；血栓形成部位主要为中心静脉置管患儿的颈静脉及锁骨下静脉、股静脉、髂静脉；87例（69.05%）为无症状性血栓，39例（30.95%）为症状性血栓，主要临床表现为下肢、颈面部或手臂肿胀等。血液净化、入住ICU≥4 d、住院时间≥7 d、使用呼吸机、置管、手术、先天性心脏病、应用激素、白细胞计数、D二聚体水平与静脉血栓发生相关，其中置管、血液净化、住院时间≥7 d、入住ICU≥4 d、手术、D二聚体水平升高是血栓发生的独立危险因素。结论：置管、血液净化、住院时间≥7 d、入住ICU≥4 d、手术、D二聚体水平升高是血栓发生的独立危险因素，针对存在相关危险因素的患者，应注意监测有无血栓形成，早发现、早治疗。 |
| 关键词: 静脉血栓 儿童 危险因素 回顾性研究方法 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2019.04.005 |
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| 基金项目: |
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| Clinical Characteristics and Risk Factors of Venous Thrombosis in Children |
| Du Sihong1, Su Yongchun2, Li Ying2, Xu Hongzhen1, Wen Xianhao1, Xiao Jianwen1, Shen Yali1, Wu Daoqi1, Liu Chengjun1, Guan Xianmin1 |
| (1. Children’s Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400016, China; 2. People’s Hospital of Yubei District of Chongqing, Chongqing 401120, China) |
| Abstract: |
| [Abstract] Objective: To investigate the clinical characteristics and risk factors of venous thrombosis in children, so as to provide reference for the prevention, early detection and treatment of venous thrombosis. Methods: Clinical data of 126 children with venous thrombosis diagnosed in Children’s Hospital of Chongqing Medical University from Jan. 2013 to Jun. 2017 were collected, the underlying diseases, age, gender, clinical manifestations, treatment and prognosis were analyzed, and the risk factors of venous thrombosis were evaluated. Results: The overall incidence of venous thrombosis was 0.41‰, which was in an increasing tendency year by year. The 2-<3 years old group took the largest proportion of children, totally 21.43%. The source department of the children mainly included hematology (mainly ALL), kidney immunology and intensive care unit. The thrombus formation site was mainly the jugular vein and subclavian vein, femoral vein and iliac vein of the children with central venous catheter. Totally 87 cases (69.05%) were asymptomatic thrombi, and 39 cases (30.95%) were symptomatic thrombosis, the main clinical manifestations were lower extremities, neck and face or arm swelling. Hemodialysis, ICU stay ≥ 4 d, length of stay ≥ 7 d, use of ventilator, catheterization, surgery, congenital heart disease, application of hormones, white blood cell count, D-dimer level and venous thrombosis were related to venous thrombosis, among which catheterization, hemodialysis, length of stay ≥ 7 d, ICU stay ≥ 4 d, surgery, increasing of D-dimer level were the independent risk factors of thrombosis. Conclusion: Catheterization, hemodialysis, length of stay ≥ 7 d, ICU stay ≥ 4 d, surgery, D-dimer level are the independent risk factors of thrombosis, for patients with relevant risk factors, closely attention should be paid to monitoring the presence or absence of thrombosis, early detection and early treatment is also necessary. |
| Key words: venous thrombosis children risk factors retrospective study |
