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ObjectiveTo explore the effect of targeted intervention measures based on risk score of venous thromboembolism （VTE）， on the prevention of senile type 2 diabetes inpatients， as well as their influence on the occurrence of venous thromboembolism. MethodsA total of 134 elderly patients with type 2 diabetes mellitus who were hospitalized in geriatrics department of Peking university third hospital during June 1， 2018 to September 30， 2018 were selected as the research subjects. All the patients were divided into control group and observation group according to random number table method， with 67 patients in each group. Patients in the control group were treated with conventional intervention methods， and patients in the observation group were treated with targeted intervention measures based on VTE risk score. After one month of intervention， the Padua score， blood glucose level and coagulation indexes of the two groups were compared. The incidence of thrombosis during the intervention period was also recorded. ResultsThe Padua score in observation group （2.09±2.17） points was significantly lower than that （3.19±2.37） points in control group （P<0.05）. The indexes of fasting blood glucose， 2h postprandial blood glucose and HbA1c in observation group were significantly lower than those in control group （P<0.05）. The fibrinogen， D-dimer， activated partial thromboplastin time and prothrombin time in observation group were significantly lower than those in control group （P<0.05）. The incidence of DVT， PVT， lower limb swelling， pain and abnormal skin color in the observation group were 4.00%， 2.00%， 2.00%， 2.00%， and 0， respectively， and in the control group were 12.00%， 10.00%， 10.00%， 12.00%， and 8.00%， respectively. The incidence of adverse events in observation group was significantly lower than that in control group （P<0.05）. ConclusionTargeted intervention based on VTE risk score can significantly reduce the risk of VTE occurrence， improve blood clotting function and blood glucose level in elderly patients with type 2 diabetes mellitus. This nursing measure has important clinical application value.
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Objective To investigate the incidence of venous thrombosis related to totally implantable access port (TIAP) in upper arm in cancer patients, and to discuss its risk factors. Methods The clinical data of a total of 1 724 patients, who received upper arm TIAP for deliverance of chemotherapy at authors' hospital during the period from February 2014 to April 2018, were collected. The general data of patients, catheterization, disease progression and incidence of venous thrombosis in upper limbs were analyzed. The univariate analysis and multivariate logistic regression analysis were used to determine the risk factors related to symptomatic thrombus. Results A total of 17 patients developed symptomatic venous thrombosis of the upper extremities, the incidence rate was 0.99％ (17/1 724) . The mean time interval from the implantation of upper arm TIAP to the diagnosis of thrombosis was 55.6 d (2-334 d) . Univariate analysis indicated that infection (P<0.01) and spontaneous catheter dislodgment (P<0.01) were significantly related to the risk of upper extremity venous thrombus (UEVT) . Multivariate binary logistic regression analysis revealed that infection (RR =16.85, P <0.01) and catheter spontaneous dislodgment (RR =101.09, P <0.01) were two important independent predictors for UVTE related to upper arm TIAP. Conclusion Infection and spontaneous catheter dislodgment are independent risk factors for upper arm TIAP-related thrombosis.
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¹⁸F-DOPA PET/CT is commonly done in patients with persistent hyperinsulinemic hypoglycemia of infancy (PHHI) to look for any focal lesion in the pancreas.We present the findings in a 20-day-old neonate with PHHI who underwent ¹⁸F-DOPA PET/CT. The scan showed diffuse uptake in the pancreas with no focal lesion, physiologic excretion into the genito-urinary system, and interestingly tracer accumulation was seen in the inferior vena cava and ilio-femoral veins which is a non-physiological site for tracer accumulation. The uptake corresponded to a large venous thrombus which was confirmed by a venous Doppler.
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Humans , Infant, Newborn , Congenital Hyperinsulinism , Pancreas , Positron Emission Tomography Computed Tomography , Thrombosis , Veins , Vena Cava, InferiorABSTRACT
Objective To prospectively study the changes of venous blood before and after travel by high speed train.Method From December 2013 to August 2015,following the appropriate inclusion and exclusion criteria,50 volunteers and 20 high speed rail crew member were recruited.Blood samples were collected,and lower extremity venous ultrasound was performed in general information,and recorded activities (including walking distance,number of steps,etc.) and drinking water volume,before and after travel.Results After 5 hours in the train,in all the participants venous blood coagulation indicators were on the rise.Doppler ultrasound examination showed:the lower extremity venous diameter increased,the venous return slowed down,the leg circumference diameter increased (all P ＜ 0.05).High speed rail crew had increased leg circumference (P ＜ 0.05).Conclusion 5 hours high-speed train travelling increases the likelihood of economy class syndrome.High speed rail crew working 10 hrs are with increased circumference of the lower extremity veins.
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Objective To prospectively study the changes of venous blood before and after travel by high speed train.Method From December 2013 to August 2015,following the appropriate inclusion and exclusion criteria,50 volunteers and 20 high speed rail crew member were recruited.Blood samples were collected,and lower extremity venous ultrasound was performed in general information,and recorded activities (including walking distance,number of steps,etc.) and drinking water volume,before and after travel.Results After 5 hours in the train,in all the participants venous blood coagulation indicators were on the rise.Doppler ultrasound examination showed:the lower extremity venous diameter increased,the venous return slowed down,the leg circumference diameter increased (all P ＜ 0.05).High speed rail crew had increased leg circumference (P ＜ 0.05).Conclusion 5 hours high-speed train travelling increases the likelihood of economy class syndrome.High speed rail crew working 10 hrs are with increased circumference of the lower extremity veins.
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We report a rare case of a 47-year-old male with posttraumatic phlegmasia cerulea dolens caused by a ruptured right external iliac vein and treated with an endovascular venous stent graft. The patient was the victim of motor vehicle accident, and suffered direct injuries to the head and abdomen. The patient had a cyanotic and swollen right lower leg. Abdominal and lower extremity computed tomography angiography revealed a large retroperitoneal hematoma caused by a ruptured right external iliac vein, and grade I liver injury. The right external iliac vein rupture was successfully treated with a venous stent graft, followed by inferior vena cava filtering, because a venous thrombus was identified below the stent graft. He initially was hemodynamically unstable but recovered following treatment. The patient was comatose when presenting at the emergency department. He was discharged, fully recovered, on hospital day 18.
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Humans , Male , Middle Aged , Abdomen , Angiography , Blood Vessel Prosthesis , Coma , Emergency Service, Hospital , Head , Hematoma , Iliac Vein , Leg , Liver , Lower Extremity , Motor Vehicles , Rupture , Thrombosis , Vena Cava, InferiorABSTRACT
Objective This study aimed to investigate whether platelet-derived growth factor CC could enhance resolution ,or-ganization and recanalization of venous thrombus .Methods The experimental models of deep vein thrombosis in rats were induced as previously described and modified .The rats were randomly divided into four groups according to the dose of PDGF-CC(Group A :0 ng/100 μL ;Group B :100 ng/100 μL ;Group C :200 ng/100 μL and Group D :500 ng/100 μL) .The samples were obtained at 7 days after operation and the expressions of protein VEGF were detected by Western blot analysis ,respectively .Immunohistochemi-cal staining was used to observe the types of the positive cells expressing vWF in thrombus sections .HE staining and Masson stai-ning were used to analyze the area of resolution and organization in venous thrombi .The capillary number was analyzed quantitative-ly by high-power microscope .The area of thrombus and collagen fiber in each section were measured and analyzed with image analy-sis software .Results Animal models of venous thrombogenesis were performed successfully .The data of Western blot analysis demonstrated that the expressions of VEGF protein were significantly increased in group C and D than group B and A ,which were no statistical significance between group C and group D at day 7 after operation .The positive cells of expressing vWF mostly located in the thrombus border and venous wall and the types of the positive cells by immunohistochemical staining were ECs .The resolu-tion rates ,organization rates and recanalization capillary numbers were significantly higher in group C and D than those in group B and A ,and those in group B were higher than those in group A .Conclusion PDGF-CC could enhance resolution ,organization and recanalization of vein thrombi effectively through therapeutic angiogenesis pathway ,which provides a novel strategy for gene thera-py of venous thromboembolism disease .
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Objective Toobservetheeffectofperioperativeuseoflowmolecularheparin(LMH)forpreventinglowerlimbdeep vein thrombosis(DVT ) in elderly hip peripheral fracture .Methods 105 cases of elderly hip peripheral fracture from July 2007 to July 2011 were divided into the LMH group(65 cases) and the conventional treatment group(40 cases) .The two groups were per-formed the physical therapy for preventing lower limb DVT .The LM H group was added with LM H for preventing DVT .The sta-tuses of DVT occurrence and the coagulation related indicators were compared between the two groups .Results In the LM H group ,the thrombus events happened in 4 cases ,accounting for 6 .15% .In the conventional treatment group ,thrombosis occurred in 13 cases ,accounting for 32 .5% .The difference between the two groups had statistical significance (P<0 .05) .Hemoglobin on post-operative 1 ,10 d was obviously improved ,the difference had statistical significance(P<0 .05) .Conclusion Using LMH has rela-tively ideal effect for preventing lower limb DVT in elderly hip peripheral fracture .
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Objective To explore the value of high frequency and color doppler ultrasonography on diagnosis of deep venous thrombus in lower extremitiy.Method 32 cases with lower extremitiy deep venous thrombi diagnosed by angiography were further examined by CDFI,36 healthy cases were randomly selected as the normal group (NOR).Results High frequency and CDFI displayed the venous image in normal lower limbs rapidly and clearly as well as the echographic features of different shapes and types of the obstructed vessels.Conclusion High frequency and CDFI as a non-invasive and realtime method is better than angiography in diagnosis of the disease.
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Objective To evaluate the efficiency of treatment of iliac-femoral venous thrombus(I-FVT)via double femoral veins.Methods Eighteen patients with I-FVT were treated with implantation of inferior vena caval filter,catheter-directed cut,balloon-directed extend and drag.Some patients were treated with ATD or OASIS catheter.After operation,the catheter was kept in iliac-femoral veins for one to six days.Meanwhile,strict anti-coagulation was necessary.Results The treatment was successful in seventeen patients,the iliac-femoral veins were patent after the opration.Swollen symptom of lower limb and pain disappeared in fifteen patients,swollen symptom of lower limb became better in two patients.The treatment was fail in one patient.Follow-up study showed no pulmonary embolization or recrudescence in all eighteen patients.Conclusion The treatment of I-FVT via double femoral veins is a safe and effective method,there are no serious complications.
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Objective:To summarize experience of 8 lower limb deep venous thrombosis(DVT) patients who used OptEase recyclable vesa cava filter(VCF) during in operations.Methods:Through collecting the clinical data of 8 patients who used OptEase recyclable vena cava filter(VCF) ,analyzing the method of recycling and releted complications.Results:No pulmonary embolism happened during and after operations,when recycle VCF implanted,vena cava graphy shows:inperfection thrombous near the filter in 1 case and vena iliaca thromb of uninjure side in 1 case too,reclaiming successfully in 5 cases,3 cases turn to permanent placement.FolIowing-up observation for 3-8 months,recurrence of limbs vena thrombosis never happened.Conclusion:The recyclable vena cava lilter could prevent plamonary embolism effectively in lower limb deep venous thrombosis patients.