《静脉血栓栓塞症诊治与预防390问》出版: PICC置管后上肢运动操结合抗凝治疗对静脉血栓发生率的干预作用

《静脉血栓栓塞症诊治与预防390问》一书是由易群、李凡敏等学者编著,在2020年10月出版于四川科学技术出版社,该书主要分为两篇,第一篇是静脉血栓栓塞症的介绍,第二篇则是静脉血栓栓塞症的诊治。本书主要是对静脉血栓栓塞症的防治与预防的相关问题进行的介绍,例如肺血栓血栓症、辅助检查、深静脉血栓栓塞的临床表现、诊断策略、治疗措施及预防等。全书通过一问一答的形式进行呈现,图文结合,是对静脉血栓栓塞症知识的科学普及。经外周穿刺置入中心静脉导管(简称PICC)主要是指经患者肘前静脉穿刺插管,将其顶端置入上腔静脉内的深静脉导管置入术。     

新生儿血栓症的诊断及治疗

血栓症是指血栓栓塞性疾病,是由血栓形成和血栓栓塞两种病理过程所引的疾病。在生理情况下,人体血栓形成与抗血栓形成的机制处于动态平衡,而病理情况下,动态平衡倾向于血栓形成而发生血栓栓塞性疾病,严重威胁生命健康。目前对成人血栓症,在多方面都已经进行了比较深入系统的研究。然而在儿童期,     

阿加曲班研究进展

阿加曲班是合成的小分子药物,为一价直接凝血酶抑制剂,阿加曲班直接与凝血酶的催化活性位点结合,不但灭活液相凝血酶,还能够灭活与纤维蛋白血栓结合的凝血酶,目前已批准用于肝素诱导的血小板减少及血栓症、经皮冠状动脉介入治疗、脑卒中溶栓等血栓性疾病.体内外研究表明,它还抑制凝血酶的其他作用,如可以抑制肿瘤转移、炎症过程及血管成形术后的再狭窄等.     

窦汇至左颈内静脉血栓形成一例的观察与护理体会

颅内静脉或静脉窦血栓形成是脑血管疾病中较为少见的特殊类型,颅内静脉窦合并颈内静脉血栓则更为罕见,国内外文献少有报道.我科近期收治1例窦汇-左颈内静脉T1段血栓形成患者,经治疗后痊愈,现将护理体会报道如下.     

脑静脉、静脉窦血栓症的急性期诊断与治疗

脑静脉、静脉窦血栓确切的发病率尚不明 ,但近年有增加倾向。本文概述脑静脉、静脉窦血栓症的病因、最新的影像诊断以及急性期治疗。一、病因和原发病脑静脉、静脉窦血栓症的原发病大体分为感染性和非感染性 ,无特定病因的亦占 2 0 %～2 5 %。( 1 )感染性　近年随抗生素的普及有减少倾向。局部感染引起的与发病部位有密切联系。中耳炎、乳突炎等耳科感染易引起乙状窦、横窦血栓症 ,副鼻窦、颜面中央软组织炎症易引起海绵静脉窦血栓症。( 2 )非感染性　有头部外伤、血液病、抗凝血酶原 缺乏症、蛋白 C、蛋白 S缺乏症等凝血异常、抗磷脂抗体…     

双嘧达莫与阿司匹林预防心房颤动血栓症的临床研究

目的:观察双嘧达莫与阿司匹林预防心房颤动血栓症疗效和安全性。方法:将612例心房颤动病人随机分为A组(204例)和B组(408例)。A组服阿司匹林100mg/次,1/日;B组在A组的基础上,加服双嘧达莫25mg/次,3/日。长期服用。随访每两个月一次,共2年。结果:A组血栓栓塞14例,B组4例。死亡A组2例;B组为零例,出血两组均为零例。两组血栓症发生率比较显著性差异(P<0.05)。结论:双嘧达莫联用阿司匹林预防心房颤动的血栓症有效且安全。     

Incidence of thrombosis after implantation of drug-eluting stents in patients with coronary artery disease

Background Randomized clinical trials have demonstrated equivalent safety to bare-metal stents after drug-eluting stents （DES） implantation. However, the DES thrombosis in randomized trials could not be comparable to those observed in clinical practice, frequently including off-label indications. This study sought to assess the incidence of DES thrombosis after implantation of DES in patients with real world coronary artery disease （CAD） in China.
Methods From December 2001 to April 2007, 8190 consecutive patients received the treatment with DES, 5412 patients completed one year follow-up： 2210 with sirolimus-eluting stent Cypher, 1238 with paclitaxel-eluting stent Taxus and 1964 with Chinese sirolimus-eluting stent Firebird, After two years of follow-up, there were 2176 patients （1245 Cypher, 558 Taxus and 373 Firebird）. All patients were treated with aspirin and clopidogrel over at least 9 months.
Results Among 8190 patients, 17 patients had acute stent thrombosis （0.24%）： 7 in the Cypher group, 4 Taxus and 6 Firebird; 23 patients had subacute stent thrombosis： 8 Cypher, 6 Taxus and 9 Firebird. The incidence of acute and subacute thrombosis was 0.49%： 0.50% Cypher, 0.63% Taxus and 0.41% Firebird. The incidence of late thrombosis at one year followup was 0.63%： 0.63% Cypher, 0.88% Taxus and 0.46% Firebird; at two year follow-up the incidence was 0.74%： 0.72% Cypher, 0.90% Taxus and 0.54% Firebird. There was no significant difference among three groups at 1 year and 2 years follow-up.
Conclusion The first generation DES in the treatment of complex lesions are safe and effective if patients are aggressively treated with dual antiplatelet agents.     

Effect of thoracic epidural blockade on plasma fibrinogen levels in patients with dilated cardiomyopathy

Objective To investigate the effects of thoracic epidural blockade (TEB) on plasma fibrinogen (FIB) levels.Methods Thirty cases of dilated cardiomyopathy (DCM) were selected randomly into a TEB group and a control group. TEB patients were subjected to a persistent TEB (T1－5), and injected with 0.5% lidocaine 3-5 ml every two or four hours for four weeks in addition to routine medicine, while patients in the control group were given routine medicine only. Plasma concentrations of FIB were measured using the micro-capillary assay. Doppler echocardiography was performed before and after the treatment. Results Plasma concentrations of FIB in two groups were greater than the normal value before the treatment. There was a significant decrease of plasma concentrations of FIB in the TEB group after the treatment (4.2±1.3 g/L vs 3.6±0.9 g/L, P&lt;0.05), but there was no significant change in the control group (4.2±1.2 g/L vs 4.3±1.9 g/L, P&gt;0.05). After four weeks of treatment, the left ventricular end diastolic diameters (LVEDD) of TEB patients were reduced (72±10 mm vs 69±10 mm, P&lt;0.05) and the left ventricular ejection fraction (LVEF) of TEB patients increased significantly (33%±13% vs 44%±14%, P&lt;0.05). In contrast, LVEDD (73±11 mm vs 73±12 mm, P&gt;0.05) and LVEF (32%±14% vs 33%±12%, P&gt;0.05) did not change significantly in the control group. Conclusions The results suggest that plasma FIB levels in patients with DCM were decreased by performing a TEB, in addition to a reduction of the enlarged cardiac cavity and an improvement in cardiac systolic dysfunction. TEB might contribute to lowering the occurrence of thrombus and thromboembolism in patients with DCM. TEB might be a promising therapeutic method to improve the prognosis of DCM patients.     

长时间上网当心血栓袭腿

据报道,一位老人比较长的时间打电脑,正打得起劲,突然感到自己的左腿疼痛,出现肿胀,有发沉感。他有点害怕,就去了医院,医生经检查后确诊,他原来是患了下肢深静脉血栓症。