Influence of Smoking on Deep Vein Thrombosis after Myocardial Infarction

As part of a study of the factors affecting the risk of deep vein thrombosis after myocardial infarction a surprising and unexplained finding was that non-smokers had a significantly higher incidence of thrombosis than cigarette smokers.     

Heparin in the Prevention of Deep Vein Thrombosis after Myocardial Infarction

A trial of continuous intravenous heparin in the prevention of deep vein thrombosis was undertaken in 48 patients who had suffered a myocardial infarction. Of the 24 control patients who did not receive heparin seven (29%) developed calf vein thrombosis as detected by the radioactive fibrinogen technique. None of the 24 heparinized patients had any evidence of venous thrombosis. This difference is significant at the 1% level.     

Streptokinase and Deep Vein Thrombosis

Five patients with deep vein thrombosis were given streptokinase. Five others with similar phlebograms were given anticoagulants, and the results assessed by examining changes in the iliac, femoral, and calf segments of the phlebograms when repeated 7-10 days later. Those of the anticoagulant group were unchanged. Four of the five given streptokinase had a reduction in the size and extent of their thrombosis. Fresh thrombus surrounded by flowing blood was lysed. Thrombus completely blocking a vein was not lysed.The indications for the use of streptokinase in deep vein thrombosis are reviewed.     

Myocardial Infarction and Deep-vein Thrombosis

In a study of 52 patients admitted into the coronary intensive care unit the incidence of deep-vein thrombosis was measured with the ¹²⁵I-fibrinogen test. Of these patients 31 were eventually confirmed to be suffering from acute myocardial infarction. This preliminary study showed that in patients with a confirmed infarct who were not treated with anticoagulants the incidence of deep-vein thrombosis was 38% and in those treated it was 5·5%. In patients who were “severely ill” from whatever the cause there was a high incidence of deep-vein thrombosis (68%).     

Increased Pulmonary Arterial Pressures after Pentazocine in Myocardial Infarction

In 15 patients with acute myocardial infarction intravenous pentazocine in a dose of either 30 or 60 mg. was followed by a significant increase in mean pulmonary arterial pressure. In the group receiving the 60-mg. dose this change was associated with a significant increase in systemic arterial pressure, total peripheral resistance, and left ventricular minute work. Because of these circulatory effects intravenous pentazocine in a dose of 60 mg. would seem to be unsuitable for the relief of pain in myocardial infarction.     

Deep Vein Thrombosis in a Queensland Hospital

Investigation in the postoperative period of 75 patients by means of the radioiodinated fibrinogen uptake method, by the use of the Doppler ultrasonic flow detector, and by clinical assessment revealed an incidence of deep vein thrombosis of only 12%. This is distinctly lower than has been reported by other investigators using the same techniques both in Australia and elsewhere. It appears from this study and associated work that the Doppler ultrasonic technique is sufficiently accurate to be of value in the clinical diagnosis of significant deep vein thrombosis.     

Postoperative Deep Vein Thrombosis in Sudanese Patients

The incidence of postoperative deep vein thrombosis diagnosed by radioisotope scanning in 100 Sudanese patients aged 40 or over was 12%. This compares with an incidence of nearly 30% in 542 patients reported from British hospitals using the same diagnostic technique. The reason for the difference is obscure and needs further investigation.     

骨创伤后深静脉血栓形成的相关危险因素分析

目的:通过比较骨创伤患者与健康人群的临床资料,分析骨创伤后深静脉血栓形成(DVT)的相关危险因素。方法:选择住院骨创伤患者但未发生深静脉血栓患者126例(骨创伤组)、DVT患者30例(DVT组)以及进行体检无创伤、心血管疾病和血栓性疾病的健康者60例(对照组)作为研究对象。D-二聚体(D-D)含量检测采用散射比浊法,纤维蛋白原(FIB)测定采用PT导出法,抗心磷脂抗体(ACA,IgA,IgM,IgG)检测采用酶联免疫法,C反应蛋白(CRP)含量检测采用速率散射比浊法。结果:骨创伤组和DVT组患者纤维蛋白原、D-二聚体均明显高于对照组,且差异均具有统计学意义(P0.05);DVT组与骨创伤组相比,此三者平均含量均升高,其中C反应蛋白含量具有统计学差异(P0.05);骨创伤组ACA阳性率与对照组ACA阳性率之间无统计学差异(P0.05);而DVT组ACA阳性率与对照组之间存在着统计学差异(P0.05);DVT组患者平均年龄明显高于骨创伤组,两者差异具有统计学意义(P0.05);DVT组患者多部位骨折发生率明显高于骨创伤组,两者差异具有统计学意义(P0.05);DVT组患者溶栓治疗前后纤维蛋白原、D-二聚体均明显降低,且差异具有统计学意义(P0.05)。结论:纤维蛋白原、D-二聚体、C反应蛋白升高和抗心磷脂抗体阳性是深静脉血栓患者的危险因素。年龄越大以及骨折情况越严重骨创伤患者发生深静脉血栓危险性越大,溶栓治疗对深静脉血栓患者的治疗效果显著。     

Detection and Management of Deep Vein Thrombosis

The accuracy of diagnosis of deep venous thrombosis is significantly improved by combining clinical evaluation with other adjunctive methods, especially fibrinogen uptake tests, technetium scans, Doppler techniques and phlebography. Using these studies, early treatment with intravenous administration of heparin can be begun and in selected cases with long-term risks, warfarin is often useful. These same drugs, in different dosage schedules, may also be helpful as prophylaxis. With these methods of treatment, thrombectomy and caval interruption are required less often. If interruption of inferior vena cava flow becomes necessary, several new methods utilizing intracaval filters are proving to be very useful.     

Optimal Electrical Stimulus for Prevention of Deep Vein Thrombosis

The most effective electrical stimulus to the calf muscles which prevents stasis in the soleal veins during operation was determined. This was subsequently used in a clinical trial and was shown to produce a 92% relative reduction in the incidence of deep vein thrombosis as determined by the ¹²⁵I-fibrinogen test.     

术前血浆D二聚体水平对全膝关节置换术后下肢深静脉血栓形成的预测

目的：探讨术前三天血浆D-二聚体水平是否与人工全膝关节置换术（TKA）术后病人下肢深静脉血栓（DVT）的发生相关。方法：89名拟行TKA的病人在术前三天时行血浆D二聚体检测。在术后并未接受预防性抗凝措施。在术后6—10天左右予以双下肢血管彩超,如果在术后更早期出现临床症状,则立即予以双下肢血管彩超检查。结果：89名行TKA手术病人均在术前行血浆D二聚体检测。术后在46名（52％）的病人的血管彩超中发现DVT。以500ng／ml为临界值,D二聚体对DVT发生预测的敏感性,特异性,阳性和阴性值分别为59％,47％,56％,和51％。结论：此研究结果表明术前血浆D二聚体无法对TKA术后DVT进行预测。     

术前血浆D二聚体水平对全膝关节置换术后下肢深静脉血栓形成的预测

目的:探讨术前三天血浆D-二聚体水平是否与人工全膝关节置换术(TKA)术后病人下肢深静脉血栓(DVT)的发生相关。方法:89名拟行TKA的病人在术前三天时行血浆D二聚体检测。在术后并未接受预防性抗凝措施。在术后6-10天左右予以双下肢血管彩超,如果在术后更早期出现临床症状,则立即予以双下肢血管彩超检查。结果:89名行TKA手术病人均在术前行血浆D二聚体检测。术后在46名(52%)的病人的血管彩超中发现DVT。以500ng/ml为临界值,D二聚体对DVT发生预测的敏感性,特异性,阳性和阴性值分别为59%,47%,56%,和51%。结论:此研究结果表明术前血浆D二聚体无法对TKA术后DVT进行预测。     

Prevention of Postoperative Deep Vein Thrombosis in Patients with Malignant Disease

We have used the ¹²⁵I-fibrinogen test to asses the value of an improved method of peroperative intermittent calf compression as a prophylactic measure against postoperative thrombosis. In a group of 99 patients over the age of 40 undergoing operations lasting more than 30 minutes the technique reduced the incidence of postoperative thrombosis by over 75%. In patients suffering from malignant disease, who are generally considered to be in the very high risk category, the reduction achieved was almost 90%.     

关节置换术后抗凝药物预防深静脉血栓及相关并发症的临床研究进展

抗凝药物有助于预防全髋关节置换术和全膝关节置换术后深静脉血栓形成,临床上最常使用的传统抗凝药物如低分子肝素、华法林等可以起到很好的预防效果。目前有一类新的口服抗凝药物已经用于临床,为关节置换术后患者带来了一种更方便、安全和有效预防血栓的治疗选择。本篇综述主要针对传统抗凝药物低分子肝素及维生素K拮抗剂,直接凝血酶抑制剂达比加群,以及选择性Xa因子抑制剂利伐沙班和阿哌沙班,对迄今为止传统抗凝药物在全髋关节置换术和全膝关节置换术患者中的临床使用经验、优缺点、以及新型口服抗凝药物最新临床用药进展进行综述,为关节置换术后患者预防深静脉血栓提供用药参考。     

Useful Measures in the Prevention of Deep Vein Thrombosis in the Legs

The three probable factors involved in deep venous thrombosis are: (1) stasis, (2) alteration in the endothelium of the veins, and (3) alteration in the clotting mechanism of the blood.Control of stasis is assisted by elevation of the foot of the bed and by the use of washable elastic stockings and early ambulation, together with foot exercises. To prevent damage to the endothelium of the veins during operation, the heels should be elevated off the operating table by means of a small rolled towel in order to take weight off the calf muscles. The use of elastic stockings demonstrated in diagrams and some of the fallacies in connection with their use are outlined.