deep-vein-thrombosis深靜脈血栓(存儲版)
【正文】 e risk of bleeding against the risk of new thrombosis. Deep vein thrombosis 第三十九頁，共四十六頁。 LowMolecularWeightHeparin。 Thank You! Xiang Yu Cheng u 第四十五頁，共四十六頁。 Treatment ? Medical Management: Surgical/Mechanical intervention ? Vena Caval Interruption Current guidelines remend against the routine use of inferior vena cava (IVC) filters for the treatment of VTE. Indications for the placement of IVC filters include a contraindication to anticoagulation, plications of anticoagulation, recurrent thromboembolism despite adequate anticoagulant therapy, and patients undergoing pulmonary embolectomy. Deep vein thrombosis 第三十七頁，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 contraindication. Deep vein thrombosis 第二十九頁，共四十六頁。 Diagnosis ? For a suspected first leg DVT in a lowprobability situation, the American College of Chest Physicians (ACCP) remends testing either Ddimer levels with moderate or high sensitivity or pression ultrasound of the proximal veins. Deep vein thrombosis 第二十一頁，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。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。 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。 Epidemiology Deep vein thrombosis * Diagnoses of DVT and PE are not mutually exclusive。 Causes The blood flow pattern in the valves can cause hypoxemia, which is worsened by venous stasis, activates pathways ones that include hypoxiainducible factor1and earlygrowthresponse protein 1. Hypoxiainducible factor1 and earlygrowthresponse protein 1 contribute to monocyte association with endothelial proteins, such as Pselectin, prompting monocytes to release tissue factorfilled microvesicles, which presumably begin clotting after binding to the endothelial surface.[9] Deep vein thrombosis 第九頁，共四十六頁。 Diagnosis Deep vein thrombosis 第十六頁，共四十六頁。 Diagnosis ? Dopler Ultrasound Deep vein thrombosis 第二十四頁，共四十六頁。 Treatment ?Medical Management: Anticoagulation ? Factor Xa Inhibitors Fondaparinux is an indirect factor Xa inhibitor that can be used as VTE prophylaxis in medical patients, those undergoing orthopedic procedures (total hip and knee arthroplasty), and those undergoing abdominal surgery. Deep vein thro
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