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1、妇科盆腔术后深静脉血栓的诊治与预防作者：胡晓榕,陈衡,黄国诚,柳红,彭碧玲,李育单位：广东医学院附属深圳福田人民医院妇产科,广东深圳【摘要】目的探讨妇科盆腔术后并发下肢深静脉血栓(DVT)的诊断治疗要点及预防措施。方法 回顾性分析我院8例妇科DVT患者的临床特点及诊断、治疗和预防的方法。结果 辅助诊断方法以彩色多普勒血流显像为最佳。治疗采用肝素或低分子肝素如速避凝抗凝治疗，均取得较好效果。全部病例确诊后即进行抗凝、溶栓治疗，血栓完全溶解1例，部分溶解7例，症状均明显改善，无肺栓塞发生。结论术前纠
2、正贫血，术中操作精细、减轻对髂静脉及其属支的刺激，术后鼓励患者早期下床活动是预防深静脉形成的主要方法；对有高危因素者术后可考虑预防性抗凝治疗；早期诊断、及时进行抗凝、溶栓治疗对DVT有较好疗效。【关键词】血栓性静脉炎;手术治疗;预防Diagnosis,treatmentandpreventionofdeepvenousthrombosisaftergynecologicoperationHUXiao-rong,CHENHeng,HUANGGuo-cheng,etal.DepartmentofOb
3、stetricsandGynecology,TheFourthPeople’sHospital,Shenzhen518033,China【Abstract】 Objective Todescribetheclinicalessentialsofdeepvenousthrombosis(DVT)afteroperationonpelvicandstudyhowtochoosethemethodsforthediagnosis,treatmentandpreventionofDVT.Me
4、thodsTheclinicalcharacteristics,themethodsofdiagnosis,treatmentandpreventionof8caseswithDVTwereanalyzedretrospectively.Results Colour-codeDopplerultrasonographywasthebestchoicetodiagnoseDVT.Heparinorlowmoleculeweightheparin(LMWH)anticoagulationwaseff
5、ectiveinpostoperativeDVT.AllpatientsunderwentimmediatelyanticoagulationandthrombolysistreatmentafterdiagnosedwithDVT.Totaldissolutionofthethrombosiswasfoundin1case,whilepartialdissolutionwasfoundin7cases.Apparentsymptomswerepalliativeinallcasesandnop
6、ulmonarythrombosisoccurred.ConclusionTreatinganemiapreoperatively,elaboratelyoperatingforreducingstimulationtotheiliacveinsystemintraoperativelyandencouragingthepatientstoleavethebedasearlvaspossiblearechiefmethodstopreventtheoccurrenceofDVT．Prophyla
7、cticemploymentofanticoagulationshouldbeconsideredforpatientswithhighriskfactors．Itiseffectiveforthepatientstoundergoanticoagulationandthrombolysisimmediatelyafterdiagnosed.【Keywords】Thrombophlebitis;surgicaltreatment;prevention深静脉血栓(deepvenousthrombo
8、sis，DVT)是外科手术，特别是盆腔手术常见、严重的并发症之一，最易受累的深静脉为髂静脉和股静脉，不但增加病人的痛苦，严重者可导致肺梗死，甚至威胁病人的生命。据文献报道DVT发病率为27.8%［1］，另有尸检资料证实，发病率为35%～52%［2］。我国目前尚无确切的统计,但近年来研究发现，妇科肿瘤术后，特别是恶性肿瘤术后DVT的发生率明显增高，由于血栓脱落引起肺栓塞致使术后并发症的发生率和死亡率亦升高［3～5］。故对于妇科盆腔术后DVT的预防和治疗应给予高度重视。现总结了我院妇科盆腔术后DVT
