Prevention of venous thrombosis
Venous thromboembolism is a high mortality rate of common diseases. Early prevention of venous thromboembolism can effectively reduce its incidence.
Venous thromboembolic disease (VTE) including deep vein thrombosis (DVT) and pulmonary embolism (PE), due to the existence in the pathogenesis of the two interrelated, now has two as a unified disease. VTE is common in the United States and Europe, the incidence rate of one thousandth, but there is an increasing trend, and with the increase in the risk of death, deep vein thrombosis and pulmonary embolism early mortality are high. Were 3.8% and 38.9%. The development of non-invasive diagnostic techniques to simplify the diagnosis of VTE, and the detection rate. However, fatal PE may be the first manifestation of the disease. In addition, the age is a risk factor for VTE and its complications, the increase in aging population will lead to future death and disability of the disease increased. The event of serious consequences of pulmonary embolism and venous thromboembolism should focus on prevention.
Prevention of venous thromboembolism
Epidemiological studies have shown that venous thromboembolism (VTE) is a patient death and disability in one of the main. PE is the most common and preventable cause of hospital deaths, preventing PE is to reduce inpatient mortality, the most important strategy. Massive PE before they occur usually without aura, so these patients a very low success rate of cardiopulmonary resuscitation. Death due to PE during hospitalization of patients ,70-80% before his death did not take into account the possibility of PE.
Most of the hospitalized patients had one or more risk factors for VTE, the existence of these risk factors are usually mixed. For example, the existence of hip fracture patients are usually older, lower limb proximal injury required surgical repair and postoperative risk factors such as braking a few weeks, so these patients have a high risk of VTE occur. As the same time, combined with tumor a higher risk of VTE occurred. For the patients should be routinely carried out the evaluation of risk factors for VTE, and targeted preventive measures. VTE risk factors in the table below.
Prevention of VTE should first conduct a risk stratification of patients and to take the group's strategy of prevention, stratification criteria include: age, nature of the disease and the patient's own factors.
VTE occurred in patients undergoing surgery affect the main factors include the type of surgery and surgical time, and the patient's own elements, according to the above factors in risk stratification of patients and take appropriate preventive measures. Table -2
Risk factors: VTE history, tumor, coagulation factor hypercoagulable state.
Merge the following risk factors, such as age, malignancy, there is neurological dysfunction, past history of VTE or surgery before the pathway.
VTE In addition to surgery or trauma and other related things, in fact, 50-70% of symptomatic thromboembolic events and 70-80% of fatal PE occurs in non-surgical patients. General medical inpatients, such as the failure to prevent occurrence when there is low to moderate risk of VTE, the incidence of asymptomatic DVT of 5-7%, and is mostly limited to distal lower extremity veins. However, some patients in severe medical illness significantly increased the risk of VTE, including: a result of congestive heart failure (New York Heart functional class III-and IV grade) or severe respiratory disease (chronic obstructive pulmonary disease, worsening) in patients hospitalized , bed and accompanied by one or more of other risk factors: the active stage of cancer, history of VTE, sepsis, acute neurological diseases (stroke with lower limb activities, inconvenient) and inflammatory bowel diseases, many medical patients are often more kinds of risk factors, but also more complex.
In addition to hospitalized patients, other special circumstances, such as long-distance travel will also increase the risk of VTE, the flight time of more than 6 hours, regardless of whether the risk of VTE, it should be taken to avoid wearing tights objects lower extremities and waist, avoid dehydration, and frequent calf muscle stretching ; a VTE risk should consider the graded compression stockings or stroke before the application of a LMWH or a sulfonamide sodium decanoate up to the liver.
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