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91.
目的探讨循证护理对预防下肢深静脉血栓的价值。方法对41例老年股骨颈骨折手术患者进行循证护理后的临床资料进行回顾性分析。结果 41例患者均无出现术后下肢深静脉血栓。结论循证护理将护理研究和护理实践有机地结合起来,提高了护理质量。 相似文献
92.
Tom Schmidt-Braekling Andrew D. Pearle David J. Mayman Geoffrey H. Westrich Wenzel Waldstein Friedrich Boettner 《The Journal of arthroplasty》2017,32(3):965-967
Background
Although venous thromboembolism is one of the leading causes of morbidity after knee arthroplasty, little data exist on the risk of deep venous thrombosis (DVT) after unicompartmental knee arthroplasty (UKA).Methods
We prospectively enrolled 112 patients undergoing UKA to determine the incidence of DVT utilizing aspirin 325 mg twice a day (BID) for 4 weeks postoperatively as DVT prophylaxis. The data were compared with a recent randomized controlled trial of patients undergoing total knee arthroplasty utilizing aspirin and Lovenox in conjunction with pneumatic compression devices.Results
One patient (0.9%) had an asymptomatic DVT, and none developed clinical symptoms of either DVT or pulmonary embolus. The incidence of asymptomatic and symptomatic DVT was 0.9% and 0%, respectively.Conclusion
Our data suggest that 325 mg of aspirin BID for 4 weeks results in a very low risk of DVT for patients undergoing UKA. 相似文献93.
94.
95.
Economic Evaluation of Enoxaparin as Postdischarge Prophylaxis for Deep Vein Thrombosis (DVT) in Elective Hip Surgery 总被引:3,自引:0,他引:3
Linda Mary Davies MSc Gerald Anthony Richardson MSc Alexander T Cohen MB BS MSc MD FRACP 《Value in health》2000,3(6):397-406
OBJECTIVES: Clinical trials indicate enoxaparin thromboprophylaxis (Clexane) can be effective and safe when used in an outpatient setting and that extending the length of thromboprophylaxis with enoxaparin to the postdischarge period may be more effective than inpatient thromboprophylaxis alone. This may increase the cost of thromboprophylaxis. The objective of the study was to estimate the expected cost-effectiveness of using enoxaparin for hospital admission only vs. enoxaparin for hospital admission and for 21 days postdischarge. METHODS: Decision analysis was used to combine probability, resource use and unit cost data, using the framework of cost-effectiveness analysis. The model used a societal perspective to estimate the expected costs of treatment and outcomes to patients undergoing orthopedic surgery for elective hip replacement. Incremental cost-effectiveness ratios were calculated to provide estimates of the cost per life gained, cost per year life year gained and cost per quality-adjusted life year gained with extended use of enoxaparin thromboprophylaxis. RESULTS: There was an expected cost per quality-adjusted life year gained of pounds 5732 associated with extended enoxaparin thromboprophylaxis. The results were sensitive to the percentage of patients who could administer enoxaparin injections at home, the rate of DVT associated with standard enoxaparin thromboprophylaxis and the rate of PE associated with standard and extended enoxaparin thromboprophylaxis. CONCLUSIONS: The analyses indicated that in most cases extended enoxaparin thromboprophylaxis resulted in increased costs for health care services. In all cases, extended thromboprophylaxis with enoxaparin was associated with improved survival and life-years gained. 相似文献
96.
97.
直接溶栓治疗急性下肢深静脉血栓的临床探讨 总被引:2,自引:0,他引:2
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。 相似文献
98.
Blood coagulation factor XIII (FXIII) is a tetrameric protein consisting of two catalytic A (FXIII-A) and two carrier/inhibitory B (FXIII-B) subunits. It is a zymogen, which becomes transformed into an active transglutaminase (FXIIIa) in the final phase of coagulation cascade by thrombin and Ca2 +. FXIII is essential for hemostasis, its deficiency results in severe bleeding diathesis. FXIIIa mechanically stabilizes fibrin by cross-linking its α-, and γ-chains. It also protects newly formed fibrin from fibrinolysis, primarily by cross-linking α2-plasmin inhibitor to fibrin. Beside the above prothrombotic effects, it is involved in limiting thrombus growth by down-regulating platelet adhesion to fibrin. Elevated FXIII level seems to be a gender-specific risk factor of both coronary artery disease and peripheral arterial disease, it represents an increased risk only in females. The association of FXIII level with the risk of ischemic stroke and venous thromboembolism was investigated only in a few studies from which no clear conclusion could be drawn. Among the FXIII subunit polymorphisms, concerning their effect on the risk of thrombotic diseases, only FXIII-A p.Val34Leu was investigated extensively. Meta-analyses of reported data suggest that this polymorphism provides a moderate protection against coronary artery disease and venous thromboembolism, but not against ischemic stroke. Gene-gene and gene-environmental interactions might modify its effect. Further studies are required to explore the effect of other FXIII subunit polymorphism on the risk of thrombotic diseases. 相似文献
99.
骨科大手术前后凝血系统相关指标改变对监测DVT发生的意义 总被引:1,自引:0,他引:1
目的:探讨骨科大手术后机体凝血系统改变有关指标检测的临床意义。方法:对39例骨科大手术患者术前24h、术后24h和72h分别进行血小板计数(PLC)、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)和纤维蛋白原定量(FIB)测定。结果:有8例并发深静脉血栓形成(DVT),其术前24h与术后24h和72h的PLC、APTT和FIB检测结果有显著性差异(P<0.05)。并发DVT组与未并发DVT组比较,术前APTT和FIB检测结果无显著性差异(P>0.05),术后24h、72h有显著性差异(P<0.05)。结论:血小板(PLC)、活化部分凝血活酶时间(APTT)和纤维蛋白原定量(FIB)动态监测对骨科大手术后并发DVT具有早期诊断价值。 相似文献
100.
M. BODDI F. BARBANI† R. ABBATE‡ M. BONIZZOLI† S. BATACCHI† E. LUCENTE M. CHIOSTRI G. F. GENSINI A. PERIS† 《Journal of thrombosis and haemostasis》2010,8(1):121-128
Summary. Background : Deep vein thrombosis (DVT) is a major complication in intensive care units (ICU) but dedicated guidelines on its management are still lacking. Objectives and Methods : This study investigated the effect of a 1-year educational program for the implementation of DVT prophylaxis on the incidence of inferior limb DVT in a mixed-bed ICU that admits high-risk surgical and trauma patients, investigated during a first retrospective phase [126 patients, SAPS II score 42 (28–54)] and a following prospective phase [264 patients, SAPS II score II 41 (27–55)]. The role of baseline and time-dependent DVT risk factors in DVT occurrence was also investigated during the prospective phase. Results : The educational program on implementation of DVT prophylaxis was associated with a significant decrease in DVT incidence from 11.9% to 4.5% ( P < 0.01) and in the mean length of ICU stay ( P < 0.01). Combined with pharmacological prophylaxis, the use of elastic compressive stockings significantly also increased in the prospective phase ( P < 0.01). The duration of mechanical ventilation, vasopressor administration and neuromuscular block were significantly different between DVT-positive and DVT-negative patients ( P < 0.01). Multivariate analysis identified neuromuscular block as the strongest independent predictor for DVT incidence. Conclusion : One-year ICU-based educational programs on implementation of DVT prophylaxis were associated with a significant decrease in the incidence of DVT and also in the length of stay in ICU. 相似文献