235例芦山地震伤员静脉血栓的筛查与防治
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摘要
目的报告四川大学华西医院芦山地震伤员静脉血栓筛查与防治的情况。方法采用血管彩色多普勒筛查该院收治的芦山地震伤员,对检出静脉血栓的伤员进行合理治疗;对未发现静脉血栓者进行早期预防。结果截至震后11天,采用血管彩色多普勒筛查仍在四川大学华西医院住院治疗的235例芦山地震伤员,共检出26例静脉血栓伤员,其中下肢静脉血栓25例,上肢静脉血栓1例。采用单纯康复干预及单纯药物干预各3例,康复干预联合药物干预20例。截至震后30天,26例静脉血栓伤员复查结果显示,11例好转(5例完全再通,6例部分再通)。地震伤员进行药物及其他干预,其中只予药物干预的3例伤员有1例静脉血栓完全再通,只予康复干预的3例伤员有1例静脉血栓部分再通,药物联合其他干预措施的20例伤员有4例完全再通,5例部分再通。结论芦山地震静脉血栓伤员大部分为老年及女性,绝大多数在ICU住院,大部分存在不同程度骨折,及时筛查防治静脉血栓可缓解局部疼痛,促使其早期进入康复治疗,防止肺栓塞等风险发生。对检出静脉血栓者采取康复和/或药物干预,对未检出静脉血栓但存在高危因素者采取康复和/或药物干预,能有效防治血栓进一步形成及血栓脱落带来的不良后果。
Objective To report the screening,prevention and treatment of venous thrombosis for Lushan earthquake victims in the West China Hospital of Sichuan University.MethodsAmong the Lushan earthquake victims screened by vascular color Doppler,those with detected venous thrombosis were treated reasonably,and those without detected venous thrombosis were prevented early.ResultsThere were total 235 Lushan earthquake victims in the hospital as of the 11th day after earthquake,and they were screened by vascular color Doppler.Among 26 cases with detected venous thrombosis,25 were lower limb venous thrombosis,and the other one was upper limb venous thrombosis.Three cases were treated by rehabilitation intervention alone,three cases were treated by drug intervention alone,and the other 20 cases were treated by both rehabilitation and drug intervention.As of 30 days after the earthquake,the reexamination results of 26 victims with venous thrombosis showed that: 11 cases improved,including 5 completely recanalization and 6 incompletely recanalization.Among the three cases with drug intervention alone,one got completely recanalization,accounted for 33.33%.Among the three cases with rehabilitation intervention alone,one got incompletely recanalization,accounted for 33.33%.Among the 20 cases with both rehabilitation and drug intervention,four got completely recanalization,accounted for 20.0%,and five got incompletely recanalization,accounted for 25.0%.ConclusionMost Lushan earthquake victims with venous thrombosis are the elderly and women,stay in the ICU,and suffer from fractures in different degrees.The timely prevention and treatment can relieve local pain,promote early entry in the rehabilitation treatment,and prevent pulmonary embolism and other risks.The rehabilitation intervention and/or drug intervention should be adopted to the victims with detected venous thrombosis as well as the victims without detected venous thrombosis but have high risk factors,for it can effectively prevent and treat the further thrombosis and other bad consequences of the detachment of thrombus.
Objective To report the screening,prevention and treatment of venous thrombosis for Lushan earthquake victims in the West China Hospital of Sichuan University.MethodsAmong the Lushan earthquake victims screened by vascular color Doppler,those with detected venous thrombosis were treated reasonably,and those without detected venous thrombosis were prevented early.ResultsThere were total 235 Lushan earthquake victims in the hospital as of the 11th day after earthquake,and they were screened by vascular color Doppler.Among 26 cases with detected venous thrombosis,25 were lower limb venous thrombosis,and the other one was upper limb venous thrombosis.Three cases were treated by rehabilitation intervention alone,three cases were treated by drug intervention alone,and the other 20 cases were treated by both rehabilitation and drug intervention.As of 30 days after the earthquake,the reexamination results of 26 victims with venous thrombosis showed that: 11 cases improved,including 5 completely recanalization and 6 incompletely recanalization.Among the three cases with drug intervention alone,one got completely recanalization,accounted for 33.33%.Among the three cases with rehabilitation intervention alone,one got incompletely recanalization,accounted for 33.33%.Among the 20 cases with both rehabilitation and drug intervention,four got completely recanalization,accounted for 20.0%,and five got incompletely recanalization,accounted for 25.0%.ConclusionMost Lushan earthquake victims with venous thrombosis are the elderly and women,stay in the ICU,and suffer from fractures in different degrees.The timely prevention and treatment can relieve local pain,promote early entry in the rehabilitation treatment,and prevent pulmonary embolism and other risks.The rehabilitation intervention and/or drug intervention should be adopted to the victims with detected venous thrombosis as well as the victims without detected venous thrombosis but have high risk factors,for it can effectively prevent and treat the further thrombosis and other bad consequences of the detachment of thrombus.
引文
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6燕铁斌.物理治疗学.北京:人民卫生出版社,2008:439-441.
2侯黎升,崔洪鹏,阮狄克,等.骨科患者静脉血栓疾病的预防.临床骨科杂志,2007,10(2):183-185.3陆再英,钟南山.内科学.第7版.北京:人民卫生出版社,2009:357-359.
4张洪斌,郑淑梅,李永民,等.脊柱外伤及手术后并发下肢深静脉血栓的预防.中国矫形外科杂志,2005,13(4):252-253.
5王轩,曹艳君,王立强.深静脉血栓形成的预防.菏泽医学专科学校学报,2012,24(2):80-81.
6燕铁斌.物理治疗学.北京:人民卫生出版社,2008:439-441.
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