CAJ | 학술논문

目的探讨儿童下肢深静脉血栓形成(DVT)的病因和治疗措施.方法回顾性分析中山大学附属第一医院1989至2009年12例儿童DVT患者的临床资料.结果 1989至1999年间,儿童DVT患者在住院儿童患者的发生率为万分之0.52;2000至2009年间,发生率为万分之3.18.尽管其发生率不高,但近10年来,呈上升趋势.12例儿童DVT患者中,感染和创伤所致的儿童DVT各占3例,是儿童DVT的主要病因.静脉导管置入所致为2例.其他病因包括肾病综合征,肿瘤,系统性红斑狼疮,和先天性血浆蛋白C缺乏各1例.2例患者合并肺梗塞,1例新生儿因患核黄疸,最终因多系统器官功能衰竭死亡.抗凝是治疗儿童DVT的主要方法,尤其在新生儿DVT患者中,仅抗凝治疗可达到良好效果.9例儿童DVT患者同时接受经外周静脉溶栓治疗.治疗过程中无严重出血并发症发生.结论由于儿童DVT发生率的不断升高和治疗的特殊性,临床上应引起对该疾病诊断和治疗的重视.
목적 탐토인동하지심정맥혈전형성(DVT)적병인화치료조시.방법 회고성분석중산대학부속제일의원1989지2009년12례인동DVT환자적림상자료.결과 1989지1999년간,인동DVT환자재주원인동환자적발생솔위만분지0.52;2000지2009년간,발생솔위만분지3.18.진관기발생솔불고,단근10년래,정상승추세.12례인동DVT환자중,감염화창상소치적인동DVT각점3례,시인동DVT적주요병인.정맥도관치입소치위2례.기타병인포괄신병종합정,종류,계통성홍반랑창,화선천성혈장단백C결핍각1례.2례환자합병폐경새,1례신생인인환핵황달,최종인다계통기관공능쇠갈사망.항응시치료인동DVT적주요방법,우기재신생인DVT환자중,부항응치료가체도량호효과.9례인동DVT환자동시접수경외주정맥용전치료.치료과정중무엄중출혈병발증발생.결론 유우인동DVT발생솔적불단승고화치료적특수성,림상상응인기대해질병진단화치료적중시.
Objective The incidence and treatment regimen for deep venous thrombosis(DVT)in hospitalized children in China are rarely reported.This report was to assess the incidence,risk factors and treatment strategy for deep venous thrombosis(DVT)among hospitalized children admitted to the First Affiliated Hospital,Sun Yat-sen University,a single tertiary-care hospital.Methods In twenty years between 1989 and 2009,12 DVTs in hospitalized children(＜17 years old)were identified in this hospital.Clinical data were retrospectively reviewed.Results The incidence of DVT in hospitalized children was low,however,it demonstrated increasing trend from 0.52 per 10 000 admissions between 1989 and 1999 to 3.18 per 10 000 admissions between 2000 and 2009 in this hospital Infection and trauma were the mostly frequent causes of DVT in hospitalized children.The catheter-related DVT was increasingly prevalent cause for DVT in hospitalized children.The other causes included nephritic syndrome,tumor,systemic lupus,and congenital plasma C protein deficiency.Two patients were complicated with pulmonary embolism.Only one neonate died due to kernicterus.Anticoagulation therapy was the first recommended treatment choice in hospitalized children with DVT,especially more low-molecular-weight heparin in recent 10 years.Antithrombotic treatment was used in 9 children older than 30 days through peripheral venous access,its application should be meticulously cautious in dosage.No bleeding occurred in all the patients.Conclusions Cautions should be given to DVT among hospitalized children due to its increasing incidence and special treatment pattern compared with adult patients.