周围血管疾病急性深静脉血栓ppt课件.ppt

* Peripheral Vascular Disease (周围血管疾病) Peripheral Vascular Disease Peripheral Vascular Disease Diseases of blood vessels outside the heart and brain Disorders of the veins Peripheral arterial disease (PAD) Peripheral Vascular Disease Acute Deep Venous Thrombosis 急性深静脉血栓 Acute Deep Venous Thrombosis Venous Thromboembolism (VTE) Acute deep venous thrombosis (DVT) Pulmonary embolism (PE) Post-thrombotic syndrome Acute Deep Venous Thrombosis Risk Factors for Acute Deep Venous Thrombosis (DVT) and Pulmonary Embolism (PE) RISK FACTOR FOR DVT OR PE ODDS RATIO 95% CONFIDENCE INTERVAL Hospitalization: ?With recent surgery 21.72 9.44–49.93 ?Without recent surgery 7.98 4.49–14.18 Trauma 12.69 4.06–39.66 Malignant neoplasm: ?With chemotherapy 6.53 2.11–20.23 ?Without chemotherapy 4.05 1.93–8.52 Prior central venous catheter or pacemaker 5.55 1.57–19.58 Prior superficial vein thrombosis 4.32 1.76–10.61 Neurologic disease with extremity paresis 3.04 1.25–7.38 Varicose veins: ?Age 45 yr 4.19 1.56–11.30 ?Age 60 yr 1.93 1.03–3.61 ?Age 75 yr 0.88 0.55–1.43 Congestive heart failure: ?Thromboembolism not categorized as a cause of death at postmortem 9.64 2.44–38.10 ?Thromboembolism categorized as a cause of death at postmortem 1.36 0.69–2.68 Acute Deep Venous Thrombosis Risk Factors for Acute Deep Venous Thrombosis (DVT) and Pulmonary Embolism (PE) Primary Hypercoagulable States Pregnancy Oral Contraceptives and Hormonal Therapy … Acute Deep Venous Thrombosis Signs and symptoms Symptoms Absence of symptoms Massive swelling Calf pain, edema, erythema, fever Cyanosis with impending venous gangrene (phlegmasia cerulea dolens，股青肿) Signs Prominent superficial veins Hypertonia and tenderness of calf Homans’ sign (pain with passive dorsiflexion of the foot ) Acute Deep Venous Thrombosis Vascular Lab Venography (“gold standard”, historically) Duplex Ultrasonography Computed tomography venography (CTV) D-Dimer Assays Acute Deep Venous Thrombosis Ascending venography May-Thurner syndr