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蛋白C路径基因多态性与静脉血栓栓塞症相关性的研究进展
静脉血栓栓塞症(venous thromboembolism,VTE)主要包括深静脉血栓形成(deep venous thrombosis,DVT)和肺血栓栓塞症(pulmonary thromboembolism,PTE),是一种遗传因素与环境因素共同参与的高发病率、高病死率、高致残率及高复发率的疾病[1-3],故不断探索和明确其危险因素,对于早期识别高危患者和开展疾病预防具有重要意义.
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肺血栓栓塞症网上资源
1 An Internet Resource on Venous Thromboembolism.主办者:University of Massachusetts Medical School.http://www.umassmed. edu/outcomes/dvt2 MEDLINE plus:Pulmonary Embolism.主办者:National Library of Medicine.http://www.nlm.nih.gov/medlineplus/pulmonaryembolism.html
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对获得性静脉血栓栓塞症发病机制的新认识
静脉血栓栓塞症(VTE)由肺栓塞(PE)和深静脉血栓形成(DVT)组成,是常见病、多发病.PE是高病死率疾病,也是全球性医疗保健问题[1-2].VTE分为遗传性和获得性两种,其中大部分为获得性,其往往发生在特定的人群中.
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低分子肝素在脊柱创伤患者血栓预防中的应用进展
静脉血栓栓塞症(venous thromboembolism,VTE)是脊柱手术的严重并发症,肺栓塞(pulmonary embolism,PE)是脊柱手术死亡的重要原因之一[1、2].脊柱创伤尤其伴脊髓损伤(spinal cord injury,SCI)的患者,卧床及制动时间较长,因而VTE发生率明显高于择期脊柱手术(脊柱畸形及退行性改变)及无SCI的患者[3].低分子肝素(low molecular weight heparin,LMWH)可减少VTE的发生率,目前已广泛应用于矫形、创伤等骨科大手术[4].然而LMWH可能增加脊柱手术后硬膜外血肿(spinal epidural hematoma,SEH)的风险,导致不可逆的神经损伤,因此在脊柱手术中的应用存在争议.目前关于LMWH在脊柱创伤患者抗凝策略的文献很少.笔者主要针对LMWH在脊柱创伤患者血栓预防中应用时的具体问题做一综述.
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静脉血栓栓塞疾病诊疗之再认识
深静脉血栓形成(deep venous thrombosis,DVT)与肺血栓栓塞症(pulmonary embolism,PE)合称为静脉血栓栓塞疾病(venous thromboembolism,VTE),是危害人类健康的常见血管疾病.VTE的预防和治疗进展一直是临床医师广泛关注的热点课题[1],本文就此做一介绍.
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全髋关节置换术后下肢深静脉血栓预防护理现状
1938年,PHilip Wiles首先提出了全髋关节成形术的概念.1960年,现代髋关节之父John Chamley发明并完成了第1例全髋关节置换术(total hip arthroplasty,THA).此后,THA得到了迅速发展,并逐步走向成熟.然而,THA的手术创伤大,其风险因子也相应较复杂,术后可能会出现诸多并发症,严重影响患者功能恢复,甚至危及生命.其中深静脉血栓形成(deep venous thrombosis,DVT)的发病率高,可达40%,其危害大,可导致深静脉瓣膜功能不全(primary venous valvular insufficiency,PVI)和肺动脉栓塞(pulmonary thromboembolism,PTE).深静脉血栓形成是指血液在深静脉内不正常地凝结,阻塞管腔,导致静脉回流障碍.国际公认的Virchow经典理论认为:引起深静脉血栓形成的因素主要有血管壁损伤、血流缓慢、血液高凝状态.医护人员必须从术前、术中、术后减少和避免这三方面因素,严格做好DVT的预防和护理.
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慢性阻塞性肺疾病急性加重期患者发生静脉血栓栓塞症的危险因素及预防
目的:探讨慢性阻塞性肺疾病急性加重期( AECOPD)患者发生静脉血栓栓塞症的危险因素及预防措施。方法比较两组的相关因素及临床指标,探讨AECOPD合并VTE危险因素,并分析预防措施。结果两组在相关因素的比较中,无显著性差异( P>0.05);卧床一周以上、口服或静脉激素、深静脉置管及D-二聚体比较,有显著性差异(P<0.05)。结论 D-二聚体水平升高、深静脉置管、长期口服、静脉注射激素及卧床是导致AECOPD患者发生静脉血栓栓塞症的主要危险因素,对上述危险因素进行科学预防有助于减少AECOPD合并VTE发生,进而提高AECOPD患者生存率。
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Strengthen the Prevention of Venous Thromboembolism
The importance of the prevention of venous thromboembolismVein thrombosis (venous thrombosis) constitute the blood-tying embolism (venous thromboembolism,VTE)disease covers a wide range,with the most important proximal lower limb deep vein thrombosis (deep venous thrombosis,DVT) and pulmonary embolism (pulmonary embolism,PE).VTE annual incidence rate of 0.15%,and age increments,similar to those of men and women.The Caucasian incidence of the highest in Asia the incidence is lower than the United States and Europe,about 1/5 according to the current survey.But up to 13 million of China' s population,the absolute number of patients is very high.
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New Type of Oral Anticoagulants
Since 1960,so far,has half a century,long-term oral vitamin K antagonists (VKA) for anticoagulation main plan,but the shortcomings of the VKA but not allow to ignore:( 1 ) the VKA effect to be slow,VKA after diagnosis should be immediate treatment,this plan have to start with unfractionated heparin (UFH),low molecular weight heparin (LMWH) and fondaparinux injection,use 5 ~ 10 d transition again after oral VKA,this plan for outpatient greatly inconvenience;(2) in the use of heparin drugs there is also monitoring problem during or the occurrence of heparin induction thrombocytopenic thrombosis disease (HITT) risk;(3) VKA treatment vulnerable to food,drugs,to VKA considerations of the interference of the individual differences are of great reaction;(4)VKA treatment window,need to narrow in close monitoring of adjusting dosage benefits under,but the present survey indicates that at least a third of patients with clinically failed to control the INR within the scope of the treatment.So send development new anticoagulants,especially oral anticoagulants listed was imminent
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The Diagnosis and Prevention, Treatment of Venous Thromboembolism
1 High-risk of venous thromboembolism(VTE)1.1 The high incidence of VTE detected in the autopsy rate was as high as 35% ~ 52%, 70% of life have not been diagnosed before. Western population epidemiological survey of its annual incidence rate was 0.1%, in particular, the highest incidence rates in Caucasians, the incidence in Asia than Europe and the United States, according to the present investigation is about the 1/5. Increased incidence of age increased, the highest incidence in the elderly up to 1%.
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Venous Thromboembolism Diagnosis and Management
February 2, 2007 - The American College of Physicians and American Academy of Family Physicians announced clinical practice guidelines for the diagnosis and management of venous thromboembolism (VTE), which claims more than 200,000 lives each year in the United States.
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Inherited Thrombophilia
The term thrombophilia includes any inherited and acquired disorders associated with an increased tendency to venous thromboembolism(VTE), the presence of inherited thrombophilic defects exposed carriers to increased risks for VTE compared with noncarriers.
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Is it Necessary to Screen Occult Cancers in the Patients with Idiopathic Venous Thromboembolism?
In 1865,Armand Trousseau first proposed that there was an association between cancer and thrombosis.In the last century,this association has been well recognized.
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Deep vein thrombosis (DVT) and pulmonary thromboembolism (PTE) are two manifesttions of venous thromboembolism (VTE) . Although the controversy remained,it has been widely accepted for many years that Chinese people have lower incidence of VTE than Caucasians with the different etiology and clinical features.
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Venous thromboembolism is a major health problem,carrying significant morbidity and mortality, with an incidence that exceeds I per 1 000. Independent risk factors for venous thromboembolism include increasing age, male gender, surgery, trauma, hospital or nursing home confinement, neurologic disease with extremity paresis, central venous catheter/transvenous pacemaker, prior superficial vein thrombosis, and varicose, among women, the risk factors include pregnancy, oral contraceptives, and hormone replacement therapy.