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Efficacy of percutaneous mechanical thrombus removal in acute lower extremity deep venous thrombosis
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作者 Jun-Qiang Xue Ping Yin +3 位作者 Jian-Ping He Hui Wei Cui-Jie Geng Yu-Xian Luo 《World Journal of Clinical Cases》 SCIE 2024年第21期4590-4600,共11页
BACKGROUND Acute lower extremity deep venous thrombosis(LEDVT)is a common vascular emergency with significant morbidity risks,including post-thrombotic syndrome(PTS)and pulmonary embolism.Traditional treatments like c... BACKGROUND Acute lower extremity deep venous thrombosis(LEDVT)is a common vascular emergency with significant morbidity risks,including post-thrombotic syndrome(PTS)and pulmonary embolism.Traditional treatments like catheter-directed thrombolysis(CDT)often result in variable success rates and complications.AIM To investigate the therapeutic efficacy of percutaneous mechanical thrombus removal in acute LEDVT.METHODS A retrospective analysis was performed to examine 58 hospitalised patients with acute LEDVT between August 2019 and August 2022.The patients were categorised into the percutaneous mechanical thrombectomy(PMT)group(n=24)and CDT group(n=32).The follow-up,safety and treatment outcomes were compared between the two groups.The main observational indexes were venous patency score,thrombus removal effect,complications,hospitalisation duration and PTS.RESULTS The venous patency score was 9.04±1.40 in the PMT group and 8.81±1.60 in the CDT group,and the thrombus clearance rate was 100%in both groups.The complication rate was 8.33%in the PMT group and 34.84%in the CDT group,and the difference was statistically significant(P<0.05).The average hospitalisation duration was 6.54±2.48 days in the PMT group and 8.14±3.56 days in the CDT group.The incidence of PTS was lower in the PMT group than in the CDT group;however,the difference was not statistically significant(P<0.05).CONCLUSION Compared with CDT,treatment of LEDVT via PMT was associated with a better thrombus clearance rate,clinical therapeutic effect and PTS prevention function,but the difference was not statistically significant.Moreover,PMT was associated with a reduced urokinase dosage,shortened hospitalisation duration and reduced incidence of complications,such as infections and small haemorrhages.These results indicate that PMT has substantial beneficial effects in the treatment of LEDVT. 展开更多
关键词 Post-thrombotic syndrome Catheter-directed thrombolysis Percutaneous mechanical thrombectomy Acute lower extremity deep venous thrombosis
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Clinical Value of Predictive Nursing Intervention on Deep Venous Thrombosis of Lower Extremities after Cesarean Section
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作者 Xiaole LI 《Medicinal Plant》 2024年第4期73-76,共4页
[Objectives]To explore the clinical nursing value of predictive nursing intervention in patients with deep venous thrombosis of lower extremities after cesarean section.[Methods]From December 2022 to April 2023,105 pr... [Objectives]To explore the clinical nursing value of predictive nursing intervention in patients with deep venous thrombosis of lower extremities after cesarean section.[Methods]From December 2022 to April 2023,105 pregnant and lying-in women who were hospitalized in the Gynecology Department of Pingquan Hospital and underwent cesarean section and met the inclusion criteria were included as the study objects.According to the medical records,they were divided into observation group(n=52 cases)and control group(n=53 cases).The clinical experimental subjects were divided into two groups.One group was the control group with routine nursing,and the other group was the observation group with predictive nursing intervention.The number of cases of deep venous thrombosis of lower extremities in the two groups was recorded to evaluate the clinical value.[Results]The incidence of deep venous thrombosis of lower extremities in the two groups after cesarean section was compared,and it was suggested that the incidence of the observation group was lower than that of the control group(P<0.05).[Conclusions]Special predictive nursing intervention can greatly reduce the incidence of deep venous thrombosis of lower extremities after cesarean section,improve nursing satisfaction,and improve clinical efficacy,which is worthy of recommendation. 展开更多
关键词 Predictive nursing intervention Cesarean section deep venous thrombosis of lower extremities Clinical value
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Establishment of a nomogram model for predicting therapy complications in patients with polycythemia and deep venous thrombosis
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作者 Ming-Xian Zhao Guo-Jie Li 《World Journal of Clinical Cases》 SCIE 2024年第22期4881-4889,共9页
BACKGROUND Patients with deep venous thrombosis(DVT)residing at high altitudes can only rely on anticoagulation therapy,missing the optimal window for surgery or thrombolysis.Concurrently,under these conditions,patien... BACKGROUND Patients with deep venous thrombosis(DVT)residing at high altitudes can only rely on anticoagulation therapy,missing the optimal window for surgery or thrombolysis.Concurrently,under these conditions,patient outcomes can be easily complicated by high-altitude polycythemia(HAPC),which increases the difficulty of treatment and the risk of recurrent thrombosis.To prevent reaching this point,effective screening and targeted interventions are crucial.Thus,this study analyzes and provides a reference for the clinical prediction of thrombosis recurrence in patients with lower-extremity DVT combined with HAPC.AIM To apply the nomogram model in the evaluation of complications in patients with HAPC and DVT who underwent anticoagulation therapy.METHODS A total of 123 patients with HAPC complicated by lower-extremity DVT were followed up for 6-12 months and divided into recurrence and non-recurrence groups according to whether they experienced recurrence of lower-extremity DVT.Clinical data and laboratory indices were compared between the groups to determine the influencing factors of thrombosis recurrence in patients with lowerextremity DVT and HAPC.This study aimed to establish and verify the value of a nomogram model for predicting the risk of thrombus recurrence.RESULTS Logistic regression analysis showed that age,immobilization during follow-up,medication compliance,compliance with wearing elastic stockings,and peripheral blood D-dimer and fibrin degradation product levels were indepen-dent risk factors for thrombosis recurrence in patients with HAPC complicated by DVT.A Hosmer-Lemeshow goodness-of-fit test demonstrated that the nomogram model established based on the results of multivariate logistic regression analysis was effective in predicting the risk of thrombosis recurrence in patients with lowerextremity DVT complicated by HAPC(χ^(2)=0.873;P>0.05).The consistency index of the model was 0.802(95%CI:0.799-0.997),indicating its good accuracy and discrimination.CONCLUSION The column chart model for the personalized prediction of thrombotic recurrence risk has good application value in predicting thrombotic recurrence in patients with lower-limb DVT combined with HAPC after discharge. 展开更多
关键词 Anticoagulation therapy deep vein thrombosis of the lower extremities High-altitude polycythemia Logistic regression analysis Nomogram model thrombosis recurrence
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Upper extremity deep vein thrombosis:An intensivist’s perspective 被引量:2
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作者 Omender Singh Deven Juneja 《World Journal of Critical Care Medicine》 2023年第3期130-138,共9页
Upper extremity deep vein thrombosis(UEDVT)is less common than lower extremity DVT but is a cause of significant morbidity and mortality in intensive care unit patients.Increasing cancer incidence,prolonged life expec... Upper extremity deep vein thrombosis(UEDVT)is less common than lower extremity DVT but is a cause of significant morbidity and mortality in intensive care unit patients.Increasing cancer incidence,prolonged life expectancy and increasing use of intravascular catheters and devices has led to an increased incidence of UEDVT.It is also associated with high rates of complications like pulmonary embolism,post-thrombotic syndrome and recurrent thrombosis.Clinical prediction scores and D-dimer may not be as useful in identifying UEDVT;hence,a high suspicion index is required for diagnosis.Doppler ultrasound is commonly employed for diagnosis,but other tests like computed tomography and magnetic resonance imaging venography may also be required in some patients.Contrast venography is rarely used in patients with clinical and ultrasound findings discrepancies.Anticoagulant therapy alone is sufficient in most patients,and thrombolysis and surgical decompression is seldom indicated.The outcome depends on the cause and underlying comorbidities. 展开更多
关键词 Catheter associated deep vein thrombosis Pacemaker associated deep vein thrombosis Paget-von Schröetter syndrome Thoracic outlet syndrome Upper extremity deep vein thrombosis
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Pitfalls and sources of error of color duplex ultrasonography in detecting deep vein thrombosis of proximal lower extremities 被引量:3
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作者 GAO Jing YI Lian-hua Auh Yong Ho 《中国医学影像技术》 CSCD 2004年第3期472-476,共5页
Purpose To analyze the sources of errors and discuss the techniques to eliminate pitfalls in detecting deep vein thrombosis (DVT) of the proximal lower extremities with color duplex ultrasonography (CDUS). Methods Six... Purpose To analyze the sources of errors and discuss the techniques to eliminate pitfalls in detecting deep vein thrombosis (DVT) of the proximal lower extremities with color duplex ultrasonography (CDUS). Methods Sixty-eight cases with initial and repeat venous CDUS of the proximal lower extremities were retrospectively reviewed. The repeat was done within 24 hours after initial CDUS scanning. Comparing repeated images to initial ones, the pitfalls and sources of error in CDUS of the proximal lower extremities were discussed. Results In total 68 repeat studies, there were 62 results as same as initials and 4 cases of false negative DVT and 2 cases of false positive DVT. Conclusion Venous CDUS in detecting DVT is observer dependent. Some pitfalls and errors can be eliminated and corrected with proper scan techniques. CDUS is the most valuable imaging modality for assessing suspected DVT in the proximal lower extremities. 展开更多
关键词 深静脉血栓 静脉造影 彩色多普勒 伪影 影像学诊断 质量控制
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Preventing Lower Extremity Deep Vein Thrombosis After Hip Fracture Surgery in Elderly Patients by Acupoint Application Combined with Pneumatic Compression Therapy 被引量:2
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作者 Xing Fu Yan Cheng 《Proceedings of Anticancer Research》 2022年第2期6-9,共4页
Objective:To investigate and analyze the long-term clinical effects of acupoint application combined with pneumatic compression therapy in the prevention of deep venous thrombosis after hip fracture surgery among the ... Objective:To investigate and analyze the long-term clinical effects of acupoint application combined with pneumatic compression therapy in the prevention of deep venous thrombosis after hip fracture surgery among the elderly.Methods:Sixty elderly patients who had undergone hip fracture surgery from February 2021 to February 2022 were selected as the research subjects.The patients were divided into two groups via drawing lots.Both the groups received nursing care,but the patients in the observation group were treated with TCM acupoint application combined with pneumatic compression therapy,whereas the control group received pneumatic compression therapy.The evaluation indicators included the patients’quality of life and complications.Results:The incidence of lower extremity deep vein thrombosis in the observation group was more than twice(0.3%),whereas the incidence of lower extremity complications in the control group was more than 6 times(20%).There was a significant difference between the two groups(p<0.05).Conclusion:Traditional Chinese medicine acupoint application combined with pneumatic compression therapy is beneficial for the prevention of postoperative lower extremity deep vein thrombosis among elderly patients.In addition,the patients’overall quality-of-life scores in both physiological and psychological aspects improved significantly,which carries significant clinical reference value. 展开更多
关键词 Acupoint application Traditional Chinese medicine Pneumatic compression therapy Minimally invasive surgery for hip fracture in elderly patients lower extremity deep vein thrombosis
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Analysis thrombolysis with anticoagulation treatment for early stage of deep vein thrombosis in the lower extremities
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作者 刘心 张梅 +2 位作者 刘陕西 祈光裕 刘亚民 《Journal of Medical Colleges of PLA(China)》 CAS 2003年第2期99-101,共3页
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
关键词 下肢深静脉血栓 溶栓治疗 抗凝血药 临床疗效
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Clinical Application of Percutaneous Transluminal Angioplasty and Stent Implantation in Acute Lower Extremity Deep Venous Thrombosis
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作者 Lei Zhang 《Journal of Advances in Medicine Science》 2018年第4期129-132,共4页
Purpose: To analyze the application of percutaneous transluminal angioplasty and stenting in acute deep venous thrombosis of lower extremities. Methods: 70 patients were divided into two groups according to the presen... Purpose: To analyze the application of percutaneous transluminal angioplasty and stenting in acute deep venous thrombosis of lower extremities. Methods: 70 patients were divided into two groups according to the presence or absence of percutaneous transluminal angioplasty and stenting. Results: The mean circumferential diameter difference between the affected limbs and the healthy limbs and the knees at 15 cm was statistically significant. The cure rate and effective rate of the research group were higher than those of the control group (P<0.05). Conclusion: Percutaneous transluminal angioplasty and stenting are of high value in acute lower extremity deep venous thrombosis. 展开更多
关键词 PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY Stent implantation Acute deep VENOUS thrombosis of lower extremity Clinical application
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Discussion on Prevention and Treatment of Lower Extremity Deep Venous Thrombosis in Orthopedic Perioperative Period from Spleen and Stomach Meridians
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作者 Jinlu Wang Qiang Zan Sirui Xie 《Journal of Clinical and Nursing Research》 2021年第1期82-89,共8页
Deep venous thrombosis of lower extremity is one of the common complications in orthopedic perioperative period.It is caused by many factors,such as peripheral vein dilation,slow blood flow;long-term immobilization,be... Deep venous thrombosis of lower extremity is one of the common complications in orthopedic perioperative period.It is caused by many factors,such as peripheral vein dilation,slow blood flow;long-term immobilization,bed rest and so on.On the one hand,it affects the early postoperative functional exercise and functional recovery,on the other hand,it increases the length of hospital stay and economic burden,increases the pain of patients and even endangers their lives.Effective treatment of traditional Chinese medicine combined with western medicine can play a better role in the prevention and treatment of lower extremity deep venous thrombosis.This study expounds the concept of spleen and stomach meridians in the prevention and treatment of lower extremity deep venous thrombosis,and puts forward some opinions on the dialectical treatment and daily conditioning of lower extremity deep venous thrombosis,hoping to provide ideas for the clinical prevention and treatment of lower extremity deep venous thrombosis in traditional Chinese medicine. 展开更多
关键词 lower extremity deep venous thrombosis Stomach meridian Spleen meridian
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Prevention and Treatment of Deep Vein Thrombosis of the Lower Limbs in Patients with Complications after Orthopedic Trauma Surgery
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作者 Ruiyao Wang Huimin Xiong Pengjun Qin 《Journal of Clinical and Nursing Research》 2021年第2期80-82,共3页
Objective:To explore and analyze on how to prevent and treat deep vein thrombosis of the lower limbs in patients with complications after orthopedic trauma surgery.Methods:The research patients were selected from the ... Objective:To explore and analyze on how to prevent and treat deep vein thrombosis of the lower limbs in patients with complications after orthopedic trauma surgery.Methods:The research patients were selected from the cases of surgical treatment of orthopedic trauma in the hospital during the past two years,and a total of 58 patients were selected.The patients were randomly divided into two groups,with 29 patients in the control group treated with conventional clinical methods;and the other 29 patients were assigned to the experimental group,where targeted preventive and therapeutic measures were administered.During the research,the number of complications of postoperative deep vein thrombosis of the lower limbs and the corresponding treatment efficacy were compared between the two groups of patients.Results:According to the results of clinical experiments,the probability of patients in the experimental group suffering from deep vein thrombosis of the lower limbs after surgery was significantly lower than that of the control group(P<0.05);in addition,when complications of deep venous thrombosis of the lower limbs occurred,the treatment efficacy of the patients in the experimental group was 96.55%,and the treatment efficacy of the patients in the control group was 82.76%.There was a significant difference between the two groups(P<0.05).Conclusion:Through clinical experiments to study and analyze the prevention and treatment measures of deep vein thrombosis in patients with complications after orthopedic trauma surgery,this research proves that active and comprehensive preventive and treatment measures can effectively reduce the number of complications and improve surgery treatment efficacy. 展开更多
关键词 Orthopedic trauma surgery Disease symptoms deep vein thrombosis of lower limbs PREVENTION TREATMENT
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Two-point compression ultrasonography: Enough to rule out lower extremity deep venous thrombosis? 被引量:2
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作者 Ralphe Bou Chebl Nader El Souki +3 位作者 Mirabelle Geha Imad Majzoub Rima Kaddoura Hady Zgheib 《World Journal of Emergency Medicine》 SCIE CAS CSCD 2021年第4期268-273,共6页
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
关键词 lower extremity deep venous thrombosis Emergency department Two-point compression ultrasonography
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Comparison of four clinical scores for the predicting lower limb deep venous thrombosis in Chinese patients 被引量:1
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作者 Li Zhu Min Liu +5 位作者 Xiaojuan Guo Jianguo Wang Youmin Guo Chen Wang Hongxia Ma Yulin Guo 《Journal of Nanjing Medical University》 2008年第4期230-233,共4页
Objective:To evaluate Wells, Kahn, St.Andr 6 and Constans scores for the prediction of deep venous thrombosis in Chinese patients. Methods:One hundred and seventy-two patients, prospectively, blinded referred for ev... Objective:To evaluate Wells, Kahn, St.Andr 6 and Constans scores for the prediction of deep venous thrombosis in Chinese patients. Methods:One hundred and seventy-two patients, prospectively, blinded referred for evaluation with four clinical-score systems for suspected deep venous thrombosis, were examined by ultrasonography. Sensitivity, specificity, positive predictive value, negative predictive value and receiver operation curves were calculated for four clinical scores. The difference between areas of the ROC curve for each of the scores was compared with others and reference line. Results:Forty-six of 172 patients had deep venous thrombosis proven by sonography. The sensitivity, specificity, positive predictive value and negative predictive value for Wells score was 91.3%, 57.1%, 43.8% and 94.7%, respectively, for Kahn score; 65.2%, 71.4%, 45.5% and 84.9%, respectively, for St.Andr 6 score; 63%, 38.9%, 27.4% and 74.2% respectively, for Constans score; 95.7%, 34.9%, 34.9% and 95.7% respectively. Area under ROV curve of Constans score was 0.814, which was similar to that of Wells score, then followed by Kahn score and that of St.Andr 6 score was no difference with the reference line. Conclusion:Based on the results of our study, the sensitivity, negative prediction value and area under ROC curve are larger for Constans score and Wells score in Chinese hospitalized patients than that of Kahn score or St.Andr 6 score. Considering the aim of the clinical assessment, Constans score and Wells score are more efficient for Chinese hospitalized patients. 展开更多
关键词 deep venous thrombosis clinical assessment lower extremity sonography
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Combined effect of Traditional Chinese Medicine decoction and low-molecular-weight heparin calcium on the postoperative deep venous thrombosis in patients with lower limb fracture 被引量:1
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作者 张惠煊 马翰斐 袁杰 《World Journal of Integrated Traditional and Western Medicine》 2015年第1期9-13,共5页
OBJECTIVE: To investigate the combined effect of Traditional Chinese Medicine(TCM) decoction and low-molecular-weight heparin calcium on deep vein thrombosis(DVT) induced by surgery in patients with lower limb fractur... OBJECTIVE: To investigate the combined effect of Traditional Chinese Medicine(TCM) decoction and low-molecular-weight heparin calcium on deep vein thrombosis(DVT) induced by surgery in patients with lower limb fracture.METHODS: Totally 86 hospitalized patients with DVT after surgery of lower limb fracture between September 2012 and January 2015 were recruited and randomly divided into control group and observation group, 43 cases in each group. The patients in the control group were treated with subcutaneous injection of low-molecular-weight heparin calcium, and those in the observation group were additionally given Danshen Injection and TCM decoction. The differences between two groups in occurrence rate, medication time, therapeutic effects,recurrence rate of thrombosis, activated partial thromboplastin time(APTT), and prothrombin time(PT) were compared.RESULTS: The occurrence rate of DVT in observation group(4.65%, 2/43) was lower than that in control group(27.91%,12/43)(P<0.05). The medication time of observation group was(6.15±2.94) d, shorter than(9.76±3.12) d in the control group(P<0.05). In observation group, 2 cases of DVT were cured(2/2); in the control group, 9 cases presented therapeutic effects and the total effective rate was 75.00%(9/12). The improvement of APTT and PT in the observation group was better than that in the control group(P<0.05).CONCLUSION: Integrative TCM decoction plus low-molecularweight heparin calcium is superior to applicaton of low-molecularweight heparin calcium alone in reducing and treating DVT in the postoperative patients with lower limb fracture. 展开更多
关键词 Surgery of lower limb fracture deep vein thrombosis Traditional Chinese Medicine LOW-MOLECULAR-WEIGHT
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重症患者下肢深静脉血栓物理治疗的研究进展 被引量:1
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作者 黄云镜 张唐馨 《中国医学创新》 CAS 2024年第3期179-184,共6页
重症患者病情较为复杂,治疗期间常出现下肢深静脉血栓(DVT),不利于其病情的恢复,虽常规药物防治效果较好,但极易引起患者出血。物理治疗可弥补药物治疗的不足,基于此,本研究针对重症患者下肢DVT的物理治疗展开综述,旨在为重症患者早期... 重症患者病情较为复杂,治疗期间常出现下肢深静脉血栓(DVT),不利于其病情的恢复,虽常规药物防治效果较好,但极易引起患者出血。物理治疗可弥补药物治疗的不足,基于此,本研究针对重症患者下肢DVT的物理治疗展开综述,旨在为重症患者早期进行物理治疗预防下肢DVT提供参考依据。 展开更多
关键词 重症患者 下肢深静脉血栓 物理治疗
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多元化健康教育模式在预防下肢骨折患者深静脉血栓中的应用
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作者 李明 陈铮 +6 位作者 王晓彦 张佳琦 张娇 张晶 薛慧 李秀婷 邸禄芹 《河北医药》 CAS 2024年第5期790-793,共4页
目的探讨多元化健康教育模式在预防下肢骨折患者深静脉血栓中的应用效果。方法采用便利抽样法,选取2021年1~12月收治的下肢骨折患者300例,按照住院时间将2021年1~6月收治的患者作为对照组,将2021年7~12月收治的患者作为观察组,每组150... 目的探讨多元化健康教育模式在预防下肢骨折患者深静脉血栓中的应用效果。方法采用便利抽样法,选取2021年1~12月收治的下肢骨折患者300例,按照住院时间将2021年1~6月收治的患者作为对照组,将2021年7~12月收治的患者作为观察组,每组150例。对照组采用常规健康教育模式,观察组采用多元化健康教育模式。比较2组患者对深静脉血栓的认知水平、基本预防措施依从性、深静脉血栓的发生率,以及患者对护理工作满意度。结果观察组患者对深静脉血栓的认知水平、对基本预防措施的依从性、护理满意度显著高于对照组(P<0.05)。观察组患者深静脉血栓发生率为16.00%低于对照组的25.33%,差异有统计学意义(P<0.05)。结论将多元化健康教育模式应用于下肢骨折患者,可提高护理效果,降低深静脉血栓的发生率,值得推广应用。 展开更多
关键词 多元化健康教育 下肢骨折 深静脉血栓 依从性
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基于诺莫图构建髋部骨折患者发生下肢深静脉血栓的预测模型
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作者 王银平 杜雪莲 +4 位作者 王亮云 黄瑞珍 罗乙舒 熊俊琴 何丽连 《广东药科大学学报》 CAS 2024年第2期144-149,共6页
目的探讨髋部骨折患者发生下肢深静脉血栓(DVT)的独立危险因素,并构建和验证列线图模型。方法选择2020年1月至2023年6月佛山市中医院骨科收治的髋部骨折患者227例为研究对象,按照7∶3比例将患者分为建模组(n=159)和验证组(n=68)。收集... 目的探讨髋部骨折患者发生下肢深静脉血栓(DVT)的独立危险因素,并构建和验证列线图模型。方法选择2020年1月至2023年6月佛山市中医院骨科收治的髋部骨折患者227例为研究对象,按照7∶3比例将患者分为建模组(n=159)和验证组(n=68)。收集患者的临床资料,采用LASSO回归和Logistic回归筛选髋部骨折患者发生DVT的独立危险因素,建立风险预测模型和列线图。采用一致性指数(C-index)、校准曲线、受试者工作特征(ROC)曲线进行评价。结果建模组159例髋部骨折中发生DVT 33例,发生率为20.89%。LASSO回归结合多因素Logistic回归分析结果显示,年龄≥70岁、糖尿病、受伤至手术时间≥5 d、低蛋白血症、D-二聚体>0.5是髋部骨折患者发生DVT的独立危险因素。基于上述危险因素绘制列线图模型,将上述5个危险因素构建列线图模型,模型区分度良好(C-index=0.932);Hosmer-Lemeshow检验显示,列线图的拟合优度良好(χ^(2)=57.625,P=0.732)。建模组和验证组发生DVT的ROC曲线下面积分别为0.932、0.821,模型准确度高。结论年龄≥70岁、糖尿病、受伤至手术时间≥5 d、低蛋白血症、D-二聚体>0.5是髋部骨折患者发生DVT的独立危险因素,基于上述因子构建的列线图模型可有效预测髋部骨折患者发生DVT的风险。 展开更多
关键词 髋部骨折 下肢深静脉血栓 危险因素 列线图
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利伐沙班和低分子肝素在老年粗隆间骨折患者围手术期的应用效果分析
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作者 傅日斌 郑欣鹏 +2 位作者 林劲松 覃基政 夏春 《中国医药》 2024年第1期93-96,共4页
目的分析利伐沙班和低分子肝素在老年粗隆间骨折患者围手术期的应用效果。方法选取2020年6月至2021年10月于厦门大学附属中山医院就诊的老年粗隆间骨折围手术期患者130例为研究对象。按随机数字表法分为观察组和对照组,每组65例。对照... 目的分析利伐沙班和低分子肝素在老年粗隆间骨折患者围手术期的应用效果。方法选取2020年6月至2021年10月于厦门大学附属中山医院就诊的老年粗隆间骨折围手术期患者130例为研究对象。按随机数字表法分为观察组和对照组,每组65例。对照组采用低分子肝素皮下注射预防血栓,观察组采用利伐沙班口服预防血栓。比较2组患者术前及术后2周的凝血指标,术后2周内下肢深静脉血栓形成(DVT)和肺栓塞的发生率,术中出血量、术后引流量及住院时间,术后1 d炎症相关指标。结果2组患者术前、术后2周组间和组内凝血相关指标差异均无统计学意义(均P>0.05)。术后观察组下肢DVT发生率显著低于对照组[4.6%(3/65)比15.4%(10/65)],差异有统计学意义(χ^(2)=4.188,P=0.041)。观察组与对照组术中出血量、术后引流量及住院时间差异均无统计学意义(均P>0.05)。术后1 d观察组降钙素原和C反应蛋白水平显著低于对照组[(0.17±0.02)μg/L比(0.22±0.01)μg/L、(20.2±2.3)mg/L比(23.9±3.6)mg/L],差异均有统计学意义(均P<0.001)。结论利伐沙班与低分子肝素在老年粗隆间骨折患者围手术期均有良好的抗凝效果及安全性,但利伐沙班预防术后下肢DVT发生的效果更显著且口服用药更方便。 展开更多
关键词 粗隆间骨折 利伐沙班 低分子肝素 下肢深静脉血栓形成
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脑卒中恢复期患者下肢深静脉血栓风险预测模型的构建及应用
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作者 朱乐英 许钦玲 +2 位作者 彭银英 阳静 黎慕佳 《广东医学》 CAS 2024年第7期904-912,共9页
目的探究脑卒中恢复期患者下肢深静脉血栓(deep vein thrombosis,DVT)的发生率及其影响因素,构建此类患者DVT风险预测模型。方法采用回顾性研究设计,选取收治的脑卒中恢复期患者431例,通过单因素和多因素logistic回归分析筛选出DVT发生... 目的探究脑卒中恢复期患者下肢深静脉血栓(deep vein thrombosis,DVT)的发生率及其影响因素,构建此类患者DVT风险预测模型。方法采用回顾性研究设计,选取收治的脑卒中恢复期患者431例,通过单因素和多因素logistic回归分析筛选出DVT发生的影响因素,构建风险预测模型并用列线图展示,应用受试者工作特征(ROC)曲线下面积、敏感度、特异度评价模型的预测效果,使用Bootstrap法对模型进行内部验证。结果431例患者中,有36例发生DVT,发生率为8.35%,建模组301例患者有26例发生DVT,发生率为8.64%,验证组130例患者有10例发生DVT,发生率为7.69%。Logistic回归分析显示MBI积分、Caprini血栓风险因素总分、平均血小板体积(MPV)、肌酐(Cr)、凝血酶时间(TT)、D-二聚体(D-Dimer)是脑卒中恢复期患者发生DVT的独立影响因素(OR值分别为0.978、1.186、0.662、0.979、1.043、1.766,均P<0.1)。以该6个因素为自变量构建列线图,建模组AUC为0.842,约登指数最大值为0.525,诊断值为0.115,敏感度为0.833,特异度为0.692;Hosmer-Lemeshow拟合优度检验2=7.458,P=0.589。验证组AUC为0.720,约登指数最大值为0.425,诊断值为0.072,敏感度为0.675,特异度为0.700,Hosmer-Lemeshow拟合优度检验2=11.414,P=0.248。结论脑卒中恢复期患者DVT发生率较高,MBI积分、Caprini血栓风险因素总分、MPV、Cr、TT、D-Dimer是其重要的影响因素,构建的列线图可个性化预测脑卒中恢复期患者DVT发生风险,有助于医护人员制订相应的干预措施。 展开更多
关键词 脑卒中 下肢深静脉血栓 影响因素 风险预测模型 列线图
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中医护理预防髋关节置换术后下肢深静脉血栓的Meta分析
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作者 张洪丽 顾晨丛 +6 位作者 杨晓敏 魏丽丽 杨毅捷 胡春娜 韩刚 杨桐 王利春 《内蒙古医学杂志》 2024年第4期428-434,共7页
目的系统评价髋关节置换术后中医护理预防下肢深静脉血栓形成的临床效果。方法计算机检索PubMed、国家知识基础设施数据库(CNKI)、维普资讯中文期刊服务平台(VIP)、万方学术期刊全文数据库(Wanfang)中关于髋关节置换术后中医护理预防下... 目的系统评价髋关节置换术后中医护理预防下肢深静脉血栓形成的临床效果。方法计算机检索PubMed、国家知识基础设施数据库(CNKI)、维普资讯中文期刊服务平台(VIP)、万方学术期刊全文数据库(Wanfang)中关于髋关节置换术后中医护理预防下肢深静脉血栓形成的文献,检索时间为2012—2022年11月。采用Cochrane干预措施系统评价手册(5.1.0版)偏倚风险评估工具对纳入的随机对照研究进行质量评价,运用RevMan5.4软件对纳入文献进行Meta分析。结果纳入11项研究,涉及1087例患者,其中研究组597例,对照组508例。Meta分析结果显示:中医护理下肢深静脉血栓发生率低于常规护理[RR=0.18,95%CI(0.09~0.35),Z=5.03,P<0.00001]。中医护理髋关节置换术后患者纤维蛋白原降低程度较常规护理明显[MD=-0.47,95%CI(-0.77~-0.16),Z=2.96,P=0.003],差异有统计学意义(P<0.05)。中医护理凝血酶原时间[MD=1.86,95%CI(-1.64~5.36),Z=1.04,P=0.30]、活化部分凝血活酶时间[MD=3.77,95%CI(-1.84~9.38),Z=1.32,P=0.19]与常规护理比较差异无统计学意义(P>0.05)。结论研究结果表明,髋关节置换术后,中医护理对预防下肢深静脉血栓形成有一定效果,且能显著降低纤维蛋白原,但在改善凝血酶原时间和活化部分凝血活酶时间方面,其效果与常规护理相比差异无统计学意义,受纳入范围和纳入研究质量的影响,上述结论尚待更多高质量的试验予以证实。 展开更多
关键词 中医护理 髋关节置换术 下肢深静脉血栓 META分析 凝血功能
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集束化护理对防治脑出血术后下肢深静脉血栓及缓解负性情绪的应用效果分析
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作者 韦颖 赖海燕 +1 位作者 梁自贞 陈羿如 《黑龙江医学》 2024年第5期615-617,共3页
目的:探讨集束化护理在预防脑出血术后患者下肢深静脉栓塞及缓解负性情绪方面的应用效果,为临床护理提供依据。方法:选取2018年11月—2020年3月广西医科大学第一附属医院收治的118例脑出血患者作为研究对象,根据入院的先后顺序将其分为... 目的:探讨集束化护理在预防脑出血术后患者下肢深静脉栓塞及缓解负性情绪方面的应用效果,为临床护理提供依据。方法:选取2018年11月—2020年3月广西医科大学第一附属医院收治的118例脑出血患者作为研究对象,根据入院的先后顺序将其分为对照组和实验组,每组各59例。对照组患者采用常规护理,实验组患者在常规护理基础上实施集束化护理干预。比较两组患者下肢深静脉血栓发生率、心理状态[焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分]、D-二聚体水平及护理满意度情况。结果:实验组患者下肢深静脉血栓发生率明显低于对照组,差异有统计学意义(χ^(2)=4.867,P<0.05)。干预后,实验组患者SAS评分、SDS评分均明显低于对照组,差异有统计学意义(t=4.985、5.012,P<0.05)。干预后,实验组患者D-二聚体水平明显低于对照组,差异有统计学意义(t=4.586,P<0.05)。实验组患者护理满意度明显高于对照组,差异有统计学意义(χ^(2)=8.768,P<0.05)。结论:对脑出血术后患者实施集束化护理干预,可预防患者下肢深静脉血栓,改善患者负性情绪,降低D-二聚体浓度,提高患者护理满意度。 展开更多
关键词 集束化护理 脑出血 下肢深静脉血栓 情绪 临床作用
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