Diagnosis and treatment of lower limb deep venous thrombosis after severe craniocerebral trauma / 中华神经医学杂志

Objective To explore the diagnosis and treatment of lower limb deep venous thrombosis (DVT) after severe craniocerebral trauma. Methods Thirty-seven cases of DVT in the lower limbs following severe craniocerebral trauma treated in our hospital between December 2003 and December 2008 were reviewed. Results All the 37 patients received anticoagnlation therapy. Thrombolytic agents were administered in 18 patients, and 14 patients underwent implantation of inferior vena cava filter. Except for one fatal case, all the cases showed relief of lower limb swelling and pain after the treatments. Eleven patients were cured, 21 showed significant improvement, and 4 had moderate improvement. Conclusions Patients sustaining craniocerebral injury are at high risk of DVT in the lower limbs, for which vascular color Doppler ultrasonography, venography, and digital subtraction angiography are effective diagnostic modalities. Anticoagulation therapy remains the primary treatment of DVT in the lower limb, and implantation of inferior vena cava filter proves valuable for preventing pulmonary embolism. Early prevention of lower limb DVT can be of vital importance.

Amikacin inhibits and dissociates the aggregation of platelets in a patient with anticoagulants-induced pseudothrombocytopenia / 中华检验医学杂志

Objective To develop an effective way to evaluate the accurate platelet count in a patient with anticoagulants-induced pseudothrombocytopenia (PTCP).Methods It was studied that various anticoagulants effect on the platelets count for an infrequent patient with anticoagulants-dependent PTCP. When vitamin B6,aminophylline,gentamicin and amikacin were separately added to four anticoagulated blood samples from anticoagulants-dependent patient within 15 min after blood withdrawal,platelets count and morphological changes of blood cells after 4 hours of incubation at room temperature were investigated. The best anti-aggregating agent and its optimal concentration among them were explored.Results The four anticoagulants all could not inhibit the aggregation of the patient's platelets.Only amikaein among the above anti-aggregating agents can prevent and dissociate the aggregation of platelets without apparent morphological changes of blood cells and the platelet counts was stable within 4 hours after blood drawn when amikacin was added either before or after blood sampling.With increasing the concentration of amikaein,the platelet counts increase and then tend to be stable.The optimal concentration of amikacin is 5 mg/ml blood.Conclusions The supplementation of amikaein either before or after blood sampling is a useful method for the diagnosis anticoagulants-dependent PTCP and for the eva/uation of platelet counts in infrequent patients with anticoagulants-dependent PTCP.