20xx年醫(yī)學(xué)專題—deep-vein-thrombosis深靜脈血栓-wenkub
2024-10-31 17 本頁面
【正文】 in thrombosis,* Diagnoses of DVT and PE are not mutually exclusive。,What Is Deep Vein Thrombosis?,The earliest case of DVT was described around 600900 BC. At some point, the increased incidence of DVT in women after childbirth was noticed, and in the late 1700s, a public health recommendation was issued to encourage women to breast feed as a means to prevent this phenomenon。 the DVT was called “milk leg“, as it was thought to result from milk building up in the leg.,第二頁，共四十六頁。 an estimated 78,511 patients received diagnoses of both DVT and PE. VTE estimates include patients with diagnoses of either DVT or PE.,第五頁，共四十六頁。s concept, alterations of the coagulation system that induce a hypercoagulable state also confer an increased risk of DVT.,第七頁，共四十六頁。,Causes,Independent Risk Factors for DVT,Age is an independent risk factor for thrombotic disease. The majority of venous thrombi occur in either the superficial or deep veins of the leg. A DVT is stationary clotting blood adhered to the deep vein of the pelvis or an extremity and usually occurs in the calf or thigh. VTE denotes an obstruction arising from the formation of a clot in the venous circulation carried by the blood from the site of origin to plug another vessel.,Deep vein thrombosis,第十頁，共四十六頁。,Signs and symptoms,In most suspected cases, DVT is ruled out after evaluation, and symptoms are more often due to other causes, such as cellulitis, Baker39。,Diagnosis,Physical Exam: symptoms Half of those with the condition HAVE NO SYMPTOMS. Signs and symptoms alone are not sufficiently sensitive or specific to make a diagnosis, but when considered in conjunction with known risk factors can help determine the likelihood of DVT.,Deep vein thrombosis,第十七頁，共四十六頁。,Diagnosis,For a suspected first leg DVT in a lowprobability situation, the American College of Chest Physicians (ACCP) recommends testing either Ddimer levels with moderate or high sensitivity or compression ultrasound of the proximal veins.,Deep vein thrombosis,第二十一頁，共四十六頁。,Diagnosis,Contrast Venography: The gold standard methods to reveal whether the venous supply has been obstructed.,Deep vein thrombosis,(a) direct manual contrast injection into the guiding catheter (direct venography technique, DVT) and (b) occlusion of coronary sinus by a SwanGanz catheter .,第二十五頁，共四十六頁。,Treatment,The main goals of treatment for DVT include prevention of PE, VTE and recurrent thrombosis. Once VTE is suspected, anticoagulation should be started immediately unless there is a con
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