本文選題：肺栓塞 + 季節(jié)�。� 參考：《大連醫(yī)科大學(xué)》2013年碩士論文

【摘要】：目的：探討大連醫(yī)科大學(xué)附屬第二醫(yī)院收治的189例急性肺栓塞（Acutepulmonary embolism, APE）患者的發(fā)病是否存在季節(jié)變化規(guī)律及其發(fā)病危險因素的變化趨勢，更好指導(dǎo)臨床實踐。 方法：收集我院2002年~2012年10年間收治的189例確診為APE的住院患者的臨床資料，采用回顧性研究方法對APE的發(fā)病季節(jié)分布規(guī)律及相關(guān)危險因素進行分析。 結(jié)果：10年間我院189例APE患者中，3月、4月APE患者較多，均為20例；計算1月~12月APE發(fā)生的構(gòu)成比約為6.88％~10.58％，但比較12個月各月份之間APE發(fā)生的構(gòu)成比，差異無統(tǒng)計學(xué)意義(P0.2)。189例APE患者中，30.69％（58/189）發(fā)生在春季，21.16％（40/189）發(fā)生在夏季，23.28％（44/189）發(fā)生在秋季，，24.87％（47/189）發(fā)生在冬季，以春季為多，但四季發(fā)病分布比較差異無統(tǒng)計學(xué)意義(P0.2)。從年齡來看，≥60歲的125例APE患者以春季發(fā)病（40例）較多，而60歲的64例APE患者以秋季發(fā)�。�20例）較多，但兩個年齡組間比較四季分布差異無統(tǒng)計學(xué)意義(P0.05)。從性別來看，100例男性APE患者以冬季發(fā)�。�28例）較多，而89例女性APE患者以春季發(fā)�。�33例）較多，但不同性別組間比較四季分布差異無統(tǒng)計學(xué)意義(P0.05)。從死亡情況來看，住院期間因APE死亡的患者共31例，春季病死率較其他季節(jié)高，但四季分布比較差異無統(tǒng)計學(xué)意義(P0.05)。189例APE患者中有180例伴有明確的高危因素，其中深靜脈血栓形成（DVT）104例、靜脈曲張或靜脈炎19例、外科手術(shù)22例、創(chuàng)傷及骨折13例、心血管疾病60例、慢性肺部疾病19例、惡性腫瘤21例、腦卒中19例、妊娠及圍產(chǎn)期1例、介入治療3例，慢性阻塞性肺疾病(COPD)13例，心力衰竭(心衰)20例，肺炎6例，腎病綜合征2例，膿毒癥3例，SLE1例，白塞病1例，先天性心臟病1例，真性紅細(xì)胞增多癥1例，潰瘍性結(jié)腸炎1例。除了外科手術(shù)后APE以夏季（12例）較多見(P0.02)外，APE發(fā)病伴隨其他高危因素的四季分布差異無統(tǒng)計學(xué)意義(均P0.05)。肺栓塞主要危險因素依次為DVT、心血管疾病、外科手術(shù)、腫瘤疾病、慢性肺部疾病、下肢靜脈曲張或靜脈炎、創(chuàng)傷及骨折等。心血管疾病在過去10年成為我院APE第二位主要危險因素。 結(jié)論： 1、2002~2012年這10年間我院APE的發(fā)生不存在明顯的季節(jié)變化規(guī)律，APE患者住院病死率與季節(jié)變化無明顯關(guān)系。 2、除了外科手術(shù)后APE以夏季較多見以外，伴隨其他高危因素的APE發(fā)病均無季節(jié)差異；過去10年，我院APE前兩位的危險因素為深靜脈血栓形成、心血管疾病。
[Abstract]:Objective: To investigate the seasonal variation in the incidence of Acutepulmonary embolism (APE) in the Second Affiliated Hospital of Dalian Medical University and the trend of its risk factors, so as to guide the clinical practice better.
Methods: the clinical data of 189 hospitalized patients who were admitted in our hospital during the 10 years of ~2012 in 2002 were collected, and the distribution of APE and related risk factors were analyzed by retrospective study.
Results: among 189 APE patients in our hospital in 10 years, there were more APE patients in March and April, all were 20 cases, and the composition ratio of APE in January ~12 month was about 6.88%~10.58%, but there was no statistically significant difference between the 12 months of each month (P0.2).189 case APE patients, 30.69% (58/189) occurred in spring, 21.16% (40/189) occurred. In the summer, 23.28% (44/189) occurred in the autumn, 24.87% (47/189) occurred in winter, in spring, but there was no significant difference in the distribution of the four seasons (P0.2). From the age, 125 cases of APE patients over 60 years of age were more in spring (40 cases), and 64 cases of APE patients 60 years old were more in autumn (20 cases), but the ratio of two age groups was compared. There was no statistically significant difference in the distribution of the four seasons (P0.05). From the gender point of view, 100 cases of male APE patients had more winter onset (28 cases), and 89 cases of female APE patients were more in spring (33 cases), but there was no statistical difference between the four seasons (P0.05). From the case of death, 31 cases of patients died of APE during hospitalization. The mortality rate in spring was higher than that in other seasons, but there was no significant difference in the distribution of the four seasons (P0.05) there were 180 cases of.189 cases with clear high risk factors, including 104 cases of deep venous thrombosis (DVT), 19 cases of varicosis or phlebitis, 22 cases of surgical operation, 13 cases of traumatic and fracture, 60 cases of cardiovascular disease, 19 cases of chronic lung disease, and evil. There were 21 cases of sexual tumor, 19 cases of stroke, 1 cases of pregnancy and perinatal period, 3 cases of interventional therapy, 13 cases of chronic obstructive pulmonary disease (COPD), 20 cases of heart failure (heart failure), 6 cases of pneumonia, 2 cases of nephrotic syndrome, 3 cases of sepsis, 1 cases of SLE1, 1 cases of Behcet disease, 1 cases of congenital heart disease, 1 cases of true red cythemia, and ulcerative colitis, except APE after surgical operation. In summer (12 cases) (12 cases), there was no significant difference in the distribution of APE with other high risk factors (all P0.05). The major risk factors for pulmonary embolism were DVT, cardiovascular disease, surgery, tumor, chronic lung disease, lower limb veins or phlebitis, trauma and fracture, and so on. Cardiovascular disease in the past 10 years It became the second major risk factor for APE in our hospital.
Conclusion:
There was no obvious seasonal change in the occurrence of APE in our hospital during the past 10 years. There was no obvious relationship between the in-hospital mortality and the seasonal variation of APE patients in 12002~2012.
2, there were no seasonal differences in the incidence of APE associated with other high-risk factors except for APE after surgery. The first two risk factors for the first two in our hospital were deep venous thrombosis and cardiovascular disease in the last 10 years.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R563.5

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