Objective Venous thromboembolism is a highly prevalent condition after polytrauma,and recognized as an important factor contributing to poor prognosis.The aim of this study was to investigate the risk factors for lowe...Objective Venous thromboembolism is a highly prevalent condition after polytrauma,and recognized as an important factor contributing to poor prognosis.The aim of this study was to investigate the risk factors for lower extremity deep venous thrombosis(LEDVT)in a severely traumatized population and to evaluate their predictive value for LEDVT.Methods This was a retrospective,single-center observational study.All subjects were severely traumatized patients who were admitted to the Traumatic Intensive Care Unit from January 2021 to May 2024.Based on Doppler ultrasound findings of both lower extremities from the time of injury to 30 days post-injury,patients who developed LEDVT were enrolled in the LEDVT group,and those who did not develop LEDVT were enrolled in the NLEDVT group.Demographic,clinical,and laboratory data were collected upon admission.Multivariable logistic regression analysis was performed to identify risk factors for LEDVT.Receiver operating characteristic(ROC)curve was used to evaluate the overall fit of the final model.Results There were 56 patients enrolled in the LEDVT group and 81 patients in the NLEDVT group.Age,Aggregate Index of Systemic Inflammation(AISI),Systemic Inflammation Response Index(SIRI),ICU length of stay,and albumin were identified as independent risk factors for LEDVT(all P<0.05).The area under their ROC curves were 0.604,0.657,0.694,0.668,and 0.405,respectively.Combined model for early clinical prediction of LEDVT in severely traumatized patients by age,SIRI,AISI,and albumin resulted in an area under the ROC curve of 0.805(95%CI:0.73-0.88,SE=0.037).Conclusion The combination of age,SIRI,AISI,and albumin has a predictive value for LEDVT in severely traumatized patients.展开更多
BACKGROUND: Deep venous thrombosis(DVT) is a major cause of morbidity and is a common presenting complaint to the emergency department(ED). Point-of-care two-point compression ultrasonography has evolved as a quick an...BACKGROUND: Deep venous thrombosis(DVT) is a major cause of morbidity and is a common presenting complaint to the emergency department(ED). Point-of-care two-point compression ultrasonography has evolved as a quick and effective way of diagnosing DVT. The purpose of this study is to validate the prevalence and distribution of venous thrombi isolated to proximal lower extremity veins, other than common femoral and popliteal veins in patients with DVT.METHODS: This is a single-center retrospective study that looked at patients presenting to the ED of a tertiary care hospital between January 2014 and August 2018. The clinical presentation and laboratory and imaging results were obtained using the hospital's electronic medical record.RESULTS: A total of 2,507 patients underwent a lower extremity duplex ultrasound during the study period. Among them, 379(15%) were included in the study. The percentages of isolated thrombi to the femoral vein and deep femoral vein were 7.92% and 0.53%, respectively. When the patients were stratified into the two groups of isolated DVT and two-point compression DVT, there were no statistically significant differences in the laboratory results between both groups. However, immobilized patients and patients with recent surgeries were more likely to have an isolated DVT.CONCLUSIONS: Thrombi isolated to proximal lower extremity veins other than the common femoral and popliteal veins make up 8.45% of DVTs. Given this significant number of missed DVTs, the authors recommend the addition of the femoral and deep femoral veins to the two-point compression exam.展开更多
Objective: To explore the effect of thrombolysis with anticoagulation treatment for early stage of deep vein thrombosis of lower extremity. Methods: The clinical data of 106 patients at the early stage of deep vein th...Objective: To explore the effect of thrombolysis with anticoagulation treatment for early stage of deep vein thrombosis of lower extremity. Methods: The clinical data of 106 patients at the early stage of deep vein thrombosis (DVT) in the lower extremities treated by thrombolysis with anticoagulation and dispersion drugs were analyzed retrospectively. Results: The thrombolytic effect was significant. After treatment, the deep veins were recanalized without regurgitation in 75.3% of the patients. The total effective rate was 100%. Only three patients had hemorrhagic complication, but none of the patients died. Conclusion: Thrombolysis with anticoagulation treatment is an effective and safe method for DVT at the early stage.展开更多
目的分析低分子肝素钙结合物理疗法对髋关节置换术后下肢深静脉血栓形成(DVT)的预防效果。方法90例实施髋关节置换术的患者,按抽签方法分为对照组和治疗组,各45例。对照组应用物理疗法治疗,治疗组则在对照组基础上应用低分子肝素钙治疗...目的分析低分子肝素钙结合物理疗法对髋关节置换术后下肢深静脉血栓形成(DVT)的预防效果。方法90例实施髋关节置换术的患者,按抽签方法分为对照组和治疗组,各45例。对照组应用物理疗法治疗,治疗组则在对照组基础上应用低分子肝素钙治疗。比较两组DVT发生情况、下肢深静脉血流速度、凝血功能指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、凝血酶时间(TT)]、血糖指标[空腹血糖(FBG)、餐后2 h血糖(2 h PBG)]、Harris评分、生活质量评分。结果治疗组的DVT发生率6.67%低于对照组的24.44%(P<0.05)。治疗组治疗后的下肢深静脉血流速度(19.93±1.66)cm/s比对照组的(17.05±1.37)cm/s更快(P<0.05)。治疗组治疗后的PT(12.93±1.16)s、APTT(34.12±3.08)s、TT(14.47±1.21)s长于对照组的(11.24±0.99)、(30.67±2.73)、(13.54±1.12)s,FIB(2.59±0.22)g/L低于对照组的(3.36±0.30)g/L(P<0.05)。治疗组与对照组治疗前后FBG、2 h PBG水平比较均无差异(P>0.05)。治疗组治疗后的Harris评分(76.39±7.30)分比对照组的(65.81±6.25)分更高(P<0.05)。治疗组治疗后的生活质量评分(71.49±6.81)分比对照组的(60.25±5.69)分更高(P<0.05)。结论对髋关节置换术患者使用低分子肝素钙结合物理疗法,可以通过改善体内的高凝状态促进下肢深静脉的血液循环,从而有效预防DVT,对于恢复髋关节功能、提高患者的生活质量具有重要的作用,值得临床推广。展开更多
基金Basic Research Spe-cial Project of Suzhou Science and Technology Bureau(SSD2024050).
文摘Objective Venous thromboembolism is a highly prevalent condition after polytrauma,and recognized as an important factor contributing to poor prognosis.The aim of this study was to investigate the risk factors for lower extremity deep venous thrombosis(LEDVT)in a severely traumatized population and to evaluate their predictive value for LEDVT.Methods This was a retrospective,single-center observational study.All subjects were severely traumatized patients who were admitted to the Traumatic Intensive Care Unit from January 2021 to May 2024.Based on Doppler ultrasound findings of both lower extremities from the time of injury to 30 days post-injury,patients who developed LEDVT were enrolled in the LEDVT group,and those who did not develop LEDVT were enrolled in the NLEDVT group.Demographic,clinical,and laboratory data were collected upon admission.Multivariable logistic regression analysis was performed to identify risk factors for LEDVT.Receiver operating characteristic(ROC)curve was used to evaluate the overall fit of the final model.Results There were 56 patients enrolled in the LEDVT group and 81 patients in the NLEDVT group.Age,Aggregate Index of Systemic Inflammation(AISI),Systemic Inflammation Response Index(SIRI),ICU length of stay,and albumin were identified as independent risk factors for LEDVT(all P<0.05).The area under their ROC curves were 0.604,0.657,0.694,0.668,and 0.405,respectively.Combined model for early clinical prediction of LEDVT in severely traumatized patients by age,SIRI,AISI,and albumin resulted in an area under the ROC curve of 0.805(95%CI:0.73-0.88,SE=0.037).Conclusion The combination of age,SIRI,AISI,and albumin has a predictive value for LEDVT in severely traumatized patients.
文摘BACKGROUND: Deep venous thrombosis(DVT) is a major cause of morbidity and is a common presenting complaint to the emergency department(ED). Point-of-care two-point compression ultrasonography has evolved as a quick and effective way of diagnosing DVT. The purpose of this study is to validate the prevalence and distribution of venous thrombi isolated to proximal lower extremity veins, other than common femoral and popliteal veins in patients with DVT.METHODS: This is a single-center retrospective study that looked at patients presenting to the ED of a tertiary care hospital between January 2014 and August 2018. The clinical presentation and laboratory and imaging results were obtained using the hospital's electronic medical record.RESULTS: A total of 2,507 patients underwent a lower extremity duplex ultrasound during the study period. Among them, 379(15%) were included in the study. The percentages of isolated thrombi to the femoral vein and deep femoral vein were 7.92% and 0.53%, respectively. When the patients were stratified into the two groups of isolated DVT and two-point compression DVT, there were no statistically significant differences in the laboratory results between both groups. However, immobilized patients and patients with recent surgeries were more likely to have an isolated DVT.CONCLUSIONS: Thrombi isolated to proximal lower extremity veins other than the common femoral and popliteal veins make up 8.45% of DVTs. Given this significant number of missed DVTs, the authors recommend the addition of the femoral and deep femoral veins to the two-point compression exam.
文摘Objective: To explore the effect of thrombolysis with anticoagulation treatment for early stage of deep vein thrombosis of lower extremity. Methods: The clinical data of 106 patients at the early stage of deep vein thrombosis (DVT) in the lower extremities treated by thrombolysis with anticoagulation and dispersion drugs were analyzed retrospectively. Results: The thrombolytic effect was significant. After treatment, the deep veins were recanalized without regurgitation in 75.3% of the patients. The total effective rate was 100%. Only three patients had hemorrhagic complication, but none of the patients died. Conclusion: Thrombolysis with anticoagulation treatment is an effective and safe method for DVT at the early stage.
文摘目的分析低分子肝素钙结合物理疗法对髋关节置换术后下肢深静脉血栓形成(DVT)的预防效果。方法90例实施髋关节置换术的患者,按抽签方法分为对照组和治疗组,各45例。对照组应用物理疗法治疗,治疗组则在对照组基础上应用低分子肝素钙治疗。比较两组DVT发生情况、下肢深静脉血流速度、凝血功能指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、凝血酶时间(TT)]、血糖指标[空腹血糖(FBG)、餐后2 h血糖(2 h PBG)]、Harris评分、生活质量评分。结果治疗组的DVT发生率6.67%低于对照组的24.44%(P<0.05)。治疗组治疗后的下肢深静脉血流速度(19.93±1.66)cm/s比对照组的(17.05±1.37)cm/s更快(P<0.05)。治疗组治疗后的PT(12.93±1.16)s、APTT(34.12±3.08)s、TT(14.47±1.21)s长于对照组的(11.24±0.99)、(30.67±2.73)、(13.54±1.12)s,FIB(2.59±0.22)g/L低于对照组的(3.36±0.30)g/L(P<0.05)。治疗组与对照组治疗前后FBG、2 h PBG水平比较均无差异(P>0.05)。治疗组治疗后的Harris评分(76.39±7.30)分比对照组的(65.81±6.25)分更高(P<0.05)。治疗组治疗后的生活质量评分(71.49±6.81)分比对照组的(60.25±5.69)分更高(P<0.05)。结论对髋关节置换术患者使用低分子肝素钙结合物理疗法,可以通过改善体内的高凝状态促进下肢深静脉的血液循环,从而有效预防DVT,对于恢复髋关节功能、提高患者的生活质量具有重要的作用,值得临床推广。
