Ultrasonic Examination Of Lower Extremity Deep Venous Thrombosis And Its Risk Factors Analysis

Objective: Through retrospective analysis of 1672 cases of lower extremity deep venous thrombosis(lower Extremity deep venous thrombosis, LEDVT) in patients with clinical data, to explore the sociodemographic characteristics of the patients, clinical characteristics, risk factors, laboratory examination and color Doppler ultrasonography, and improve the detection rate of CDU in diagnosing LEDVT, enhance the cognition of the related risk factors and to provide a reliable basis for early diagnosis, treatment and prevention of LEDVT.Method: Select 1672 patients who diagnosed with LEDVT in China-Japan Union Hospital between April, 2014 and October, 2015. Retrospective analysis the clinical information, lesion site, involving the scope, type and nature of such as records. Using SPSS 19.0 and Excel2007 statistics software of gender, age, lesion, thrombosis of the type and properties, related risk factors of statistical analysis, the measurement data to `x+s, count data to rate or constituent ratio, and the count data, x2 test, and the difference is statistically significant with P < 0.05.Results: 1.LEDVT: 1672 patients with LEDVT, 793 cases of male, 879 cases of female, male to female ratio is: 1:1.11, between male and female patients gender difference no statistical significance(P > 0.05); age of onset is 16-92 years old, average age(53.56 + 22.31) years; > 40 patients in 1550, the proportion of 92.7%, significantly higher than less than or equal to 40 patients(P < 0.01); and is less than or equal to 40 patients, female incidence rate than men, accounting for 72.9%. 2. LEDVT patients with lesions and type: in this study, 1672 cases of LEDVT patients, thrombosis occurs only in the left lower extremity 899 cases(53.8%), only the right lower limb 557(33.3%), double lower limbs of 216 cases(12.9%), the difference among the three had statistical significance(P < 0.01), the calf muscular venous thrombosis most common(33.8%); thrombus type peripheral type accounted for 48.5%, significantly higher than the other types(P < 0.01). The incidence rates of central type, peripheral type and mixed type were 24%, 48.5%, 27.5%, and, respectively, the peripheral type with the highest(48.5%), and were significantly higher than those in other types(P<0.01) 3.LEDVT in patients with staging and ultrasound manifestations: acute thrombosis, subacute thrombosis and old thrombus formation were 1286 cases(76.9%), 281 cases(16.8%), 105 cases(6.2%), including acute thrombus formation was significantly higher than that of other types(P < 0.01), and acute thrombosis of the two-dimensional ultrasound has specificity, easy to differentiate with other types. Two-dimensional ultrasonography of acute LEDVT thrombosis is characteristic, performance for vein diameter significantly increased width and larger tension and thrombi were low- and very low echo, sometimes the edge of the thrombus was floating; ultrasonic features of subacute is not obvious, and ultrasonography of acute phase compared to the vein diameter gradually retracted, the thrombus echo gradually increased and fixing thrombosis; chronic thrombosis is often shown as diameter, tube wall fuzzy and unclear demarcation with thrombosis, thrombosis often was not homogeneous and high echo; Doppler ultrasound according to the vein occlusion show different degree. 4. In 1672 patients in this group, 1613 patients(96.6%) present with signs and symptoms. The most common clinical manifestations for limb pain and limb swelling; suffering from limb pain 1166 cases(72.3%), which the central type 29.6%, peripheral 42.1%, mixed type 28.3%; suffering from limb swelling 1079 cases(64.5%), which the central type 38.4%, peripheral 26.2%, mixed type 35.4%; two symptoms were 864 cases(51.7%), mainly in the central type, which accounted for 38.9%. 5.Laboratory examination of patients with LEDVT: results indicate that with development of MPV three influences the hemodynamic indexes of platelet mean volume(mean plateletvolume) hemoglobin content of erythrocyte hematocrit and red blood cell count increased prevalence rate increased; coagulation routine check check to D-Dimer(D-D) anomaly and fiber plasma protein by(FG) anomaly; blood examination results show in HGL decreased and TG increased. 6. risk factors: The statistical results show that ranked the top two risk factors for age > 40 years old(92.7%), trauma or surgery(40.9%), the operation factors in orthopedic surgery(42.1%) is most common and orthopaedic postoperative LEDVT average bed time for(8.16 ± 2.11) days. The earliest time for 3 days after the operation, more common in 3-10 days after operation. Age < 40 years old(122 cases) and > 40 years(155 cases) two groups of patients with the risk factors by x2 test comparison, it is found that the age < 40 group of risk factors in pregnancy or postpartum ratio was significantly higher than that of > 40 years old group(P < 0.01). The proportion of age > 40 years old group of risk factors in malignant tumor, trauma or surgery, bedridden or sedentary, diabetes, hypertension, coronary heart disease was significantly higher than that in the less than or equal to 40 years old group(P < 0.01); other risk factors compared the difference between the two groups had no statistical significance(P > 0.05). Simple LEDVT and complicated with PE patients in the two groups group the risk factors by x2 test comparison, LEDVT group and LEDVT-PE groups of patients with operation or injury(P = 0.003), smoking(P < 0.001) and coronary heart disease(P = 0.026) and malignant tumor(P = 0.017), infection diseases(P < 0.001) with significant difference. Other risk factors compared the difference between the two groups had no statistical significance(P > 0.05).Conclusions: 1 LEDVT was most commonly involved in the left lower extremity, and the peripheral type was the most frequently involved; 2 LEDVT hospitalized patients with older age, surgical / trauma, bedridden / sedentary common; with the growth of the age, the incidence rate was higher; and surgical / trauma, smoking, coronary heart disease, malignant tumor, infection diseases in patients with PE incidence was significantly higher than that of other factors; 3 By clinical evaluation, D- two polymer determination, color Doppler ultrasound examination of the three constitutes a non-invasive diagnostic strategy, is the first choice for LEDVT diagnosis; 4. The first time ultrasonography of LEDVT has important significance, help to clinical for LEDVT early diagnosis and disease evaluation and according to the characteristics of different types of lesions take for treatment measures, and to review provided on the basis of the comparison.