上肢深静脉血栓症: 592名患者的前性注册
Hylton V Joffe1, Nils Kucher, Victor F Tapson
1Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass 02115, USA.
Circulation
|September 9, 2004
概括
上肢深静脉血栓塞 (UEDVT) 的危险因素不同于下肢深静脉血栓塞. 中心静脉导管 (CVC) 的使用是UEDVT最强的预测因素,突出了预防和理解的差距.
科学领域:
- 血管医学 血管医学
- 血栓形成研究研究
- 流行病学 流行病学
背景情况:
- 上肢深静脉血栓塞 (UEDVT) 可以自发发生,也可以作为起器或中央静脉导管 (CVC) 等医疗设备的并发症,以及癌症.
- 了解UEDVT的独特特征对于有效的临床管理至关重要.
研究的目的:
- 为了比较CVC相关的UEDVT,非CVC相关的UEDVT和下肢深静脉血栓 (DVT) 的人口统计,风险因素和管理.
- 确定UEDVT和非CVC相关的UEDVT的独立预测因子.
- 评估UEDVT患者目前的预防策略.
主要方法:
- 使用了可能的美国多中心DVT注册表.
- 人口统计,临床和管理数据收集了324名 (6%) 心血管疾病相关的UEDVT患者,268名 (5%) 非心血管疾病相关的UEDVT患者和4796名 (89%) 下肢DVT患者.
- 使用倾向分析和多变量逻辑回归来确定独立的预测因素.
主要成果:
- 中心静脉导管 (CVC) 的使用被确定为UEDVT最强的独立预测因素 (OR,7.3).
- 非CVC相关的UEDVT患者比下肢DVT患者更年轻,更少白色,更瘦,更容易吸烟.
- 非CVC相关的UEDVT的独立预测因素包括年轻年龄 (<67岁),较低的BMI (<25 kg/m2) 和住院治疗. 只有20%没有禁忌的UEDVT患者接受了预防.
结论:
- 无线EDVT的风险因素与下肢DVT的风险因素有很大的不同.
- 研究结果表明,目前对UEDVT的理解和预防存在缺陷,这表明了未来研究的领域.
- 该研究强调了CVC在UEDVT发展中的关键作用,以及需要改进的预防策略.
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