上肢(shàngzhī)深静脉血栓upperextremitydeepvenousthrombosisUEDVT第一页，共二十九页。定义(dìngyì)•腋静脉、锁骨下静脉、桡静脉、尺静脉、肱静脉、颈内静脉、头臂干静脉•最常见：腋静脉、锁骨下静脉•原发性：约占20%•继发性：指存在(cúnzài)危险因素的深静脉血栓形成，约占80%CucMai,M.D.H.M.,UpperextremityDeepVenousThrombosisAReview.TheAmericanJournalofMedicine,2011.第二页，共二十九页。第三页，共二十九页。流行病学(liúxínbìnxué)ɡɡ时间作者住院病人/nUEDVT/n发生率%1998Kroger1600003340.21998-2006SyedMustafa44163650.15KrogerK,ScheloC,GockeC,etal.ColourDopplersonographicdiagnosisofupperlimbvenousthromboses[J].ClinSci(Lond),1998,94(6):657-661.SyedMustafa,M.,etal.,upperextremitydeepveinthrombosis.CHEST,2003第四页，共二十九页。DVT中所占比例(bǐlì)时间作者DVT/nUEDVT/n发生率%1999Spencer4836914%2004HyltonV545159211%SpencerFAECLD.UpperExtremityDeepVeinThrombosisACommunity-Based[J].AmJMed,2007,8(120):678-684.HyltonV.JoffeNKVF.Upper-ExtremityDeepVeinThrombosisAProspectiveRegistryof592Patients[J].Circulation,2004,12(110):1605-1611.第五页，共二十九页。危险(wēixiǎn)因素原发性上肢深静脉(jìngmài)血栓：•遗传性血栓形成倾向：蛋白C、蛋白s或抗凝血酶、凝血因子Ⅲ缺乏，凝血因子VLeiden突变和凝血酶原G20210A突变•解剖结构异常：Paget-Schroetter综合征Grant,J.D.,etal.,Diagnosisandmanagementofupperextremitydeep-veinthrombosisinadults.ThrombHaemost,2012.第六页，共二十九页。继发性上肢深静脉血栓•CVC置入：45%与CVC有关•肿瘤：38%与恶性肿瘤有关•其他：起搏器、30天内手术史或制动史、个人或者家族深静脉血栓栓塞史、正在(zhèngzài)接受化疗、伴随疾病（高血压、糖尿病、神经系统疾病、30内肺部感染）MunozFJ,MismettiP,PoggioR,etal.Clinicaloutcomeofpatientswithupper-extremitydeepveinthrombosis:resultsfromtheRIETERegistry[J].Chest,2008,133(1):143-148第七页，共二十九页。RIETE研究(yánjiū)多国家、多中心DVTUEDVTCVC肿瘤例数n11564512228196比例%/4.4%45%UEDVT中比例38%UEDVT中比例MunozFJ,MismettiP,PoggioR,etal.Clinicaloutcomeofpatientswithupper-extremitydeepveinthrombosis:resultsfromtheRIETERegistry[J].Chest,2008,133(1):...
