摘要
目的:探讨基层医院下肢深静脉血栓形成(LDVT)诊治现状,以发现诊治过程中的不妥之处,为提高基层医院诊治水平提供依据。方法:随机选取益阳市20个乡镇医院医师(医师组)作为研究对象,了解其对DVT的诊断和治疗的方法。同时对2011年6月-2013年6月本院收治的DVT患者(患者组)发放调查表,了解其就诊过程和诊断治疗方法,并进行随诊。结果:调查发现广大乡镇医院医师对LDVT非常陌生,诊断仅靠下肢水肿、疼痛等临床症状(93.5%,447/478);治疗上仅予以中药活血化瘀治疗(99.2%,474/478),基本未采取预防肺栓塞的措施,后期亦未穿弹力袜和抗凝治疗,使PTS发生的几率和时间提前。绝大部分患者首次就诊于中医科(83.7%,170/203),耽搁了就诊时间,遗留PTS。其中患者组中小于3 d组12个月PTS发生率(4%,1/23),大于7 d组(60%,15/25),两者比较差异有统计学意义(P<0.01)。结论:基层医院下肢深静脉血栓形成误诊率高,诊断方法单一,治疗不规范,导致死亡率增加,PTS发生率明显增加,亟待改善诊治水平。
Objective：To explore the diagnosis and treatment of deep venous thrombosis of the lower extremity, in order to find out deficiency of the process of diagnosis and treatment,provide basis for improving the level of diagnosis and treatment in the basic hospital.Method：The doctors（the physicians group）were randomly selected from 20 township hospital of Yiyang city as the research object,understanding the diagnosis and treatment of DVT. At the same time, admitted to our hospital for patients with DVT（the patient group）in June 2011 to June 2013 were issued questionnaires, the diagnosis and treatment were studied,and followed-up.Result：The investigation showed that the majority of township hospital doctors were very familiar with the LDVT,diagnosis by lower extremity edema,pain and other clinical symptoms （93.5%,447/478）,the treatment only to depend on Traditional Chinese Medicine（99.2%,474/478）,didn’t take in the prevention of pulmonary embolism,later also not wear elastic stockings and anticoagulant therapy,increased the incidence of PTS and ahead of time. Most of the patients first received treatment in the department of traditional Chinese medicine （83.7%,170/203）,delayed treatment time,effected PTS（60%,15/25）. The incidence of PTS in 12 months in the less than 3 d group（4%,1/23）,was more than the 7 d group（60%,15/25）,which compare the difference was statistically significant（P〈0.01）.Conclusion：The basic hospital deep venous thrombosis of the lower extremity misdiagnosis rate is high,a single diagnosis method,treatment is not standardized,resulting in increased mortality,the incidence of PTS was significantly increased,need to improve diagnosis level.
出处
《中国医学创新》
CAS
2014年第30期4-6,共3页
Medical Innovation of China
基金
2011年度湖南省医药卫生科研计划课题项目(C2011-021)
关键词
深静脉血栓形成
诊治
Deep venous thrombosis
Diagnosis and treatment
