High prevalence of detectable deep venous thrombosis in patients with acute pulmonary embolism
High prevalence of detectable deep venous thrombosis in patients with acute pulmonary embolism
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DOI：
10.1378/chest.116.4.903
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发表时间：
1999-10-01
期刊：
影响因子：
9.6
通讯作者：
Simonneau, G
中科院分区：
文献类型：
--
作者：
Girard, P;Musset, D;Simonneau, G
研究目的：由于具体的研究是不可用的，可检测到的“残留”深静脉血栓形成（DVT）在急性肺栓塞（PE）患者的确切患病率是unknowed.Design：连续患者的临床记录和放射学文件的审查。设定：一所大学医院的肺部疾病和放射科，患者：5年内在肺部疾病科住院诊断为急性PE的所有患者在此期间，PE的诊断完全基于肺血管造影，并且在证实急性PE的患者中常规进行双侧下肢静脉造影。测量和结果：在228例血管造影证实PE的连续患者中，213例在诊断后48小时内进行了双侧下肢静脉造影，静脉造影证实174例患者发生DVT（81.7%; 95%置信区间，76.5 - 86.9%），包括128例近端DVT患者（60%），仅72例（42%）DVT患者出现DVT体征或症状。近期接受盆腔手术或分娩的患者中可检测到的DVT的患病率显著较低（6/12，50%），无论其个体风险因素如何（p < 0.05），静脉造影正常的患者的平均肺血管阻塞明显低于可检测到DVT的患者（37.6 +/- 20.9% vs 48.4 +/- 21.7%; p = 0.007），结论：下肢静脉造影显示血管造影证实的PE患者中残余DVT的患病率较高（82%），在疑似或证实的PE患者的诊断和治疗管理中应考虑这些数据。
Study objectives: Because specific studies are unavailable, the exact prevalence of detectable "residual" deep venous thrombosis (DVT) in patients with acute pulmonary embolism (PE) is unknown.Design: Review of clinical records and radiologic documents of consecutive patients. Setting: Pulmonary diseases and radiology departments at a university hospital,Patients: All patients hospitalized in the Department of Pulmonary Diseases with a diagnosis of acute PE during a 5-year period (1984 to 1988), During this period, the diagnosis of PE was based exclusively on pulmonary angiography, and bilateral lower limb venography was routine in patients with proven acute PE.Measurements and results: Among 228 consecutive patients with angiography-proven PE, 213 underwent bilateral lower limb venography within; 48 h of the diagnosis, Venography demonstrated DVT in 174 patients (81.7%; 95% confidence interval, 76.5 to 86.9%), including 128 patients (60%) with proximal DVT, Signs or symptoms of DVT were present in only 72 patients (42%) with DVT. The prevalence of detectable DVT was-significantly lower in patients with recent pelvic surgery or delivery (6 of 12, 50%) than in the other patients, whatever their individual risk factors (p < 0.05), The mean pulmonary vascular obstruction was significantly lower in patients with normal venography than in patients with detectable DVT (37.6 +/- 20.9% vs 48.4 +/- 21.7%; p = 0.007),Conclusions: Lower limb venography demonstrates a high prevalence (82%) of residual DVT in patients with angiography-proven PE, These data should be taken into account in the diagnostic and therapeutic management of patients with suspected or proven PE.