| Objective:Stroke is a common and frequent disease in clinical neurology, the annual incidence of which is more than1.6million people in China. Deep venous thrombosis (DVT) is a common complication in stroke. Due to the disturbance of consciousness, prolonged bed rest, dehydration, combined other organ damage and other factors, patients with acute stroke could easily cause deep vein thrombosis. DVT often shows insidious onset and rapid progress and if not treated in time, DVT can cause the ischemia and necrosis of limb. It was easily for the thrombosis to break off to result pulmonary thromboembolism. At present, the epidemiological study on the prevalence characteristics of hospitalized stroke patients with DVT in China are rare and small. This study was aimed to further study the general characteristics, clinical features, laboratory examinations characteristics, treatment and prognosis of stroke patients with DVT in order to provide detailed clinical data for early prevention, early diagnosis and early treatment of the hospitalized stroke patients with DVT.Methods and materials:1.The hospitalized stroke patients from January1990to December2011admitted in the Department of Neurology, Shandong Provincial Hospital were selected for the survey, including ischemic stroke and hemorrhagic stroke with a total of5783cases.2. Through medical record retrieval system, according to the DVT diagnostic criteria,43cases with the discharge diagnosis of deep vein thrombosis (DVT) were screened from the above stroke patients.3. The clinical datas of all cases in this study were collected, including:general information, history of present illness, past history, imaging studies, the complications of DVT, the risk factors for DVT, clinical symptoms and signs, laboratory examinations results, treatment, outcome,etc. The retrospective study was used to analyze and summarize the clinical features.4. All statistical analyzes were used by SPSS version13.0statistical package for statistical computing. A student t tests was used in the measurement datas between two groups and the chi-square test was used in the count data between two groups. P <0.05was statistically significantResults:1.The total of DVT with stroke was43cases,25males(58.14%),18females(41.86%), the ratio of male to female was25:18, with a mean age (62.7±2.53) years old ranging36-88years old. The two peaks of incidence were61-70years old and71-80years old. The Ischemic stroke with DVT was30cases and the hemorrhagic stroke with DVT was13cases. There was no significant difference in gender distribution in DVT with different types of stroke (P>0.05).2. The stroke lesions of15cases were located in the left hemisphere group (34.9%),20cases in the right hemisphere group (46.5%),8cases in the bilateral lesions (18.6%). The distributions of stroke types in different hemisphere stroke showed significant differences (P<0.05). The lesions in the cerebral cortex were15cases (34.9%), subcortical were20cases (46.5%), both cortical and subcortical lesions were8cases (18.6%). There were significant differences in the distributions of stroke types in different image lesions (P<0.05). The anterior circulation groups were24cases (55.8%), the posterior circulation groups were8cases (18.6%), the anterior and posterior circulation groups were11cases (25.6%). The distributions of limb in the different blood supply cycle showed no significant difference (P>0.05).3. The most three common past history and personal history in DVT were:31cases hypertension (72.1%),18cases diabetes (41.9%),13cases alcoholism (30.2%).4. In young and middle-aged group (30-60years),5cases were mild disturbance of consciousness (waking and drowsiness),9cases were severe disturbance of consciousness (lethargy, and coma). In old age group (61-90years),8cases were mild disturbance of consciousness,21cases were severe disturbance of consciousness. There was no significant difference in the distribution (P>0.05).5. The most three clinical symptoms of DVT were:35cases limb swelling (81.4%),29cases skin temperature increased (69.8%),17cases limb pain (39.5%). The gender distributions of limb swelling and limb pain showed no significant difference (P>0.05). The gender distribution of skin temperature showed significant difference (P <0.05).6. The43patients with DVT were all low limb deep venous thrombosis,29cases were the left lower limb (67.4%);11cases were the right lower limb (25.6%);3cases were the both lower limbs (7.0%). The three most common veins were the femoral vein in13cases (28.3%), gastrocnemius venous plexus in10cases (23.9%) and tibiofibular vein in seven cases (15.2%).17cases were peripheral type of DVT (37.0%),21cases were central type of DVT (45.7%) and8cases were mixed type of DVT (17.4%). There were significant differences in the incidence rates of the left and right lower limbs in peripheral and central type of DVT (P<0.05). There was no significant difference in the incidence rates of the left and right lower limbs in mixed type of DVT (P>0.05). There was no significant difference in the incidence rates of ischemic stroke and hemorrhagic stroke in peripheral, central and mixed DVT (P>0.05).7. In young and middle-aged group (30-60years),3cases were mild muscle obstacles (3-5stages),12cases were severe muscle obstacles (0-2stages). In old age group (61-90years),8cases were mild muscle obstacles,23cases were severe muscle obstacles. There was no significant difference in the distribution (P>0.05).8.8cases (18.6%) of DVT occurred in the1-7days of stroke,25cases (58.1%) of8-14days,10cases (23.3%) of15-21days. The majority of DVT in ischemic stroke occurred in the8-14days (70.0%), The majority of DVT in hemorrhagic stroke occurred in the15-21days.9. There was no significant difference of WBC, GLU, blood lipids, coagulation indexes in the different types of stroke or different DVT genotyping patients.10. In the43patients with DVT,5patients were cured,36cases improved and2patients died. Conclusion:Conclusion:l.The two peaks of incidence were61-70years old and71-80years old. There was no significant difference in gender distribution in DVT with different types of stroke.2. There were significant differences of stroke type and limb distribution in different hemisphere patients. There was significant difference of stroke types in different image lesion of the stroke. There was no significant difference of limb distribution in different brain blood supply cycles.3. The common past histories of DVT patients were hypertension, diabetes, alcoholism.4. There was no significant difference in the two level of consciousness (mild and severe disturbance of consciousness) in the two age groups (young and old group).5. The most common clinical symptoms of DVT was limb swelling and there was a significant difference of skin temperature in different gender.6. The most common venous was the femoral vein. The central type of DVT was the most, the peripheral type of DVT was the second and the mixed type of DVT was the least. There were significant differences in the incidence rates of the left and right lower limbs in peripheral and central type of DVT. There was no significant difference of stroke type in different DVT sub-type. There was no significant difference in the incidence rates of the left and right lower limbs in mixed type of DVT.7. There was no significant difference in the two levels of muscle force (mild and severe muscle obstacles) in the two age groups (young and old group).8. There was a significant difference in the onset time of DVT in different stroke types.9. There was no significant difference of WBC, GLU, blood lipids, coagulation indexes in the different types of stroke or different DVT genotyping patients. |
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