肺栓塞防治策略(护士继教2011.5).ppt

Blood flow from the left ventricle， through blood vessels to all parts of the body (except the lungs) and back to the heart (to the right atrium) is spoken of as systemic circulation. The left ventricle pumps blood into the ascending aorta. From here， it flows into arteries that carry it into the various tissue， and organs of the body. Blood moves from arteries to arterioles to capillaries. Blood flows out of each organ by way of its venules and then its veins to drain into the inferior vena Cava. The vena Cava returns venous blood to the heart to complete the systemic circulation. Pulmonary circulation blood moves from the right atrium to the left ventricle to the pulmonary artery to lung arterioles and capillaries. Here， exchange of gases between blood and air takes place， converting deoxygenated blood to oxygenated blood. This oxygenated blood then flows on， through lung venules into pulmonary veins and returns to the left atrium of the heart. From the left atrium it enters the left ventricle to be pumPTEd through the systemic circulation. The structure of each type of blood vessel is modified according to its function and location. One common structural characteristic of all the vessels is the smooth endothelial lining known as the intima. All arteries and veins are constructed of three layers. The walls of the venules and veins are much thinner and less elastic than the arteries and arterioles. The veins and venules also contain blood under much lower pressures and many of the veins have valves. 在全部1102例入选患者中，有的患者在第14天没有进行静脉造影或超声检查，有的患者的检查结果无法评价，这两类患者共计236例，因此，主要药效终点的资料仅包括其他的866例患者[1]。 到第14天，安慰剂组中静脉血栓栓塞的发生率为14.9%，依诺肝素40mg治疗组中的发生率仅为5.5%，即相对危险性显著下降了63%（p0.001）。在同一时间点，安慰剂组中有3例患者发生了有临床症状的非致死性肺栓塞，与之相比，依诺肝素20 mg治疗组中同样的病例有1例[1]。 接受依诺肝素20mg治疗的患者与接受安慰剂治疗的患者相比，其预后没有显示显著差异。共有4例患者发生了有临床症状的肺栓塞，其中有3例属于安慰剂组，有1例是依诺肝素20毫克治疗组[1]。 1. Samama et al. A comparison of enoxaparin with placebo for the prevention of venous thromboembolism in ac