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Objective:To analyze the clinical characteristics of hospitalized patients with distal deep venous thrombosis (DDVT).Methods:Medical records of patients without DDVT at admission and discharged from January 1,2021 to June 30,2021, were retrospectively reviewed. During the pre-hospitalization and hospitalization period the ultrasonography was performed for detection of DDVT. The venous thromboembolism (VTE) risk scores were evaluated with Caprini scale for surgical patients, and evaluated with Padua scalefor nonsurgical patients.Results:A total of 16 400 patients, 8 827 males and 7 573 females with a mean age of (63.8±14.2) years (14 to 101 years) were enrolled, among whom DDVT occurred in 1 193 patients (DDVT group), including 73 cases developed during pre-hospitalization; meanwhile 124 patients were diagnosed as deep vein thrombosis(DVT), and 15 083 patients without DVT served as non-DDVT group. The detection rate of DDVT in patients with medium/high VTE risk scorewas significantly higher than thatin low-risk patients [12.8% (982/7 644) vs. 2.4% (211/8 756), χ2=659.10, P<0.001]. The detection rate of DDVT for medium/high VTE risk score group was the highest in emergency intensive care unite and intensive care unite(ICU; 34.3%, 68/198), followed by that in departments of rehabilitation (25.7%, 45/175), neurology (19.9%,37/186), neurosurgery(19.4%,83/428), respiratory medicine(19.0%,56/295) and orthopedics (15.4%, 378/2 451).The detection rate of DDVT increased with age.The lowest detection rate was found in the age group 14 to 40 years, for low VTE risk score group it was 0.5%(4/770), for the medium/high VTE risk score group it was 3.0%(11/362, χ2=10.10, P<0.001).In patients over 75 years of age, the detection rate of DDVT was 5.2%(85/1 624) in low VTE risk score group, and 18.0%(389/2 158) in medium/high VTE risk score(χ2=138.82, P<0.001).The mean age of the DDVT group was older than that of non-DDVT group [(71.0±12.1) vs. (63.2±14.2) years, t=21.14, P<0.001]. The abnormality rate of D-dimer level in DDVT patients was significantly higher than that in non-DDVT patients [71.4%(813/1 138) vs. 25.4%(3 492/13 770), χ2=1 086.80, P<0.001]. The median length of hospital stay was significantly longer than that of the non-DDVT group [11.0 (8.0, 19.0) vs. 6.0 (4.0, 10.0)d, Z=-26.67, P<0.001].The risk factors for non-surgical DDVT patients were age, bed rest for ≥3 d, and acute infection; while the risk factors for surgical DDVT patients were age, fracture in hip, pelvis or lower limb, bedridden for ≥3 d and body mass index (BMI)>25 (kg/m 2). Conclusion:The detection rate of DDVT is higher in hospitalized patients, especially for those in ICU and rehabilitation department, and those over 75 years old with high VTE score. Advanced age, fracture or immobilization, and long-term bed rest are the main risk factors for DDVT.
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Objective To investigate the effects of splenctomy on the idiopathic thrombocytopenic purpura (ITP) patients. Methods 9 patients with ITP were involved in the present study,who were performed with splenecto-my because of refractoriness, contraindicatiun and intolerance during corticosteroids therapy. Results The average platelet count of the patients before operation was 35×109/L,while the first,4th and 7th day after operation,the aver-age platelet count was 98×109/L, 179×109/L and 235×109/L. After follow-up for 6 months,there were 7 cases having marked improvement, and the total effective rate was 88.9%. Conclusion Splenectomy is a recommendable method for ITP, expecially for those are inefficient,incompatible and intolerated to continually pharmacotherapy.
