直接溶栓治疗急性下肢深静脉血栓的临床探讨

依临床表现及顺行性下肢静脉造影诊断的７３例急性下肢深静脉血栓，经病变远肢端静脉滴注蝮蛇抗酶行五接溶栓治疗，蝮蛇抗栓酶剂量为０．０２５ＩＵ／ｋｇ体重，每天１次，２周为１疗程，２２例治疗后经造影复查。该法安全、方便且有赦，无明显利作用，值得推广应用。     

Low Rate of Intrahospital Deep Venous Thrombosis in Acutely Ill Medical Patients: Results From the AURELIO Study

Objective

To evaluate the effect of hospitalization on deep venous thrombosis (DVT) rate by the cumulative incidence of DVT in the proximal venous tract of the lower limbs at admission and discharge.

Fatal pulmonary embolism following conservatively managed tendo achilles rupture-A case report

IntroductionTendo achilles (TA) ruptures are commonly encountered in orthopaedic practice. These can be managed operatively or conservatively depending on various factors like patient age, activity levels, co morbidities, patient expectations and surgeon preference. They are usually treated in plaster cast immobilisation if managed conservatively.Case reportWe present a case of fatal pulmonary embolism following conservatively managed Tendo achilles (TA) rupture in a young man treated as an orthopaedic outpatient.DiscussionThere are no current clear guidelines on venous thromboembolism (VTE) prophylaxis in conservatively managed outpatients with cast immobilisation.ConclusionOur case report highlights the importance of recognition of this aspect of patient management and reviews the current literature available on this debatable topic.     

Succinct Review of the New VTE Prevention and Management Guidelines

Venous thromboembolism is a major source of morbidity and mortality in the United States. The American College of Chest Physicians Antithrombotic Guidelines, 9th edition, includes a large number of clinical practice recommendations regarding the diagnosis, treatment, and prevention of venous thromboembolism. This succinct clinical review of these guidelines specifically focuses on the evaluation, treatment, and prevention of venous thromboembolic disease.     

下肢深静脉血栓形成的防治及护理进展

下肢深静脉血栓形成（Deep Vein Thrombosis,DVT)是临床常见病、多发病，发病率有逐年上升的趋势，近年来有关下肢DVT的研究取得了可喜的成绩，在护理上也提出了一些新的观点。现将下肢DVT的发生机理、防治及护理研究进展作一介绍。     

髋臼骨折后下肢深静脉血栓形成

目的 探讨深静脉血栓(DVT)形成的机理及防治对策。方法 对32例下肢DVT患者行超声多普勒检查,记录并分析受伤肢体的左右侧别、库血的输入、年龄、糖尿病、心脑血管疾病、肥胖等因素与下肢DVT形成的关系。结果 在同期164例髋臼骨折患者中DVT 32例(19.5％);近端DVT 7例(21.9％),远端DVT 18例(56.2％),全静脉DVT7例(21.9％);左下肢DVT 21例(65.6％),右下肢11例(34.4％);库血输入28例(88.8％);使用止血带8例(25％);患者平均年龄为63岁。结论 髋臼骨折患者中,存在高危因素者DVT发生率较高,建议对围手术期存在高危因素患者采取适当的预防性治疗,对发生DVT者行常规有效的治疗。     

气压式循环驱动器预防老年骨科术后下肢DVT效果观察及护理

目的:探讨气压式循环驱动器预防老年骨科患者术后下肢深静脉血栓形成(DVT)的效果及护理方法。方法:将98例老年骨科术后患者随机分为观察组和对照组各49例,对照组行常规抗凝治疗及护理,观察组在此基础上使用气压式循环驱动器进行辅助治疗。比较两组患者卧床72 h后下肢DVT情况。结果:观察组下肢DVT发生率明显低于对照组(P<0.05)。结论:老年骨科术后患者应用气压式循环驱动器辅助治疗可有效预防下肢DVT。     

妇产科术后下肢深静脉血栓的预防和并发症的护理

目的 探讨妇科手术后并发下肢深静脉血栓形成( DVT) 的预防和护理对策.方法 自2003年4月至2010年8月,我院妇产科手术后并发下肢深静脉血栓共15例,发生时间为术后2～6 d,发病年龄为26～74岁,现回顾性分析这55例并发DVT患者的预防及护理措施.结果 55例并发DVT患者在早期干预及有效的护理之后,54例好转痊愈出院,1例因栓子脱落导致肺动脉栓塞予转院治疗.结论 妇科术后发生DVT与多种因素有关,根据其危险因素及手术大小,对高危人群进行早期干预及加强护理能提高DVT的治愈率.

Abstract：

Objective To discuss the prevention and nursing of DVT after obstetric and gynecologic operations.Methods To retrospectively analyze the prevention and nursing for 55 patients with DVT from April, 2003 to October,2010.DVT occurrence was 2 to 6 days after operation and the morbidity age was from 26 to 74.Results Fifty-four patients of them were cured with effective nursing measures, but one case was transferred to another hospital because the embolus dropped out and induced pulmonary embolism.Conclusions The occurrence of DVT after gynecological operation is related to many factors. Earlier intervention and intensive care of high-risk groups can reduce the incidence of DVT based on the factor of danger and the size of operation.