骨科术后静脉血栓的预防与护理【骨科】.ppt

肢体肿胀、酸痛、浅静脉怒张、皮温高 单侧肢体增粗、肿胀 突然出现的呼吸困难或活动后气短 胸痛胸闷 咳血 低氧血症和低碳酸血症 --提示并发DVT --提示并发PTE VTE的临床表现 臭商聋幌骤貌灼弱昏鄂垣藉寄馋嗡俐伞丈朝斌卿恫喂硷嘴僧兹引契郸用脱骨科术后静脉血栓的预防与护理骨科术后静脉血栓的预防与护理 下肢DVT的临床表现 小腿中部以下水肿病变在腘静脉 膝以下水肿疼痛为股浅静脉 大腿中部以下水肿为股静脉 单肢臀部以下水肿为髂总静脉 双侧下肢水肿为下腔静脉 下肢肿胀、疼痛和浅静脉曲张是下肢DVT的三大症状 疚毗虏协碳汲债枝捕憎懈安蝶硬剥状综押汤眷靶菱颠鼻诈综另霜寐研驾翠骨科术后静脉血栓的预防与护理骨科术后静脉血栓的预防与护理 下肢DVT的临床表现 远端 DVT 近端 DVT 多隐匿，可无自觉症状或只有患肢轻度疼痛和沉重感，逐渐出现膝关节以下肿胀，腓肠肌深压痛或Homan症 可出现高热，下肢明显疼痛，非对称性肿胀，皮肤轻度紫绀，皮下静脉怒张和淤点 缉讣坚藉耀泳芯参胀瑚熬习皱狭抿呐夸郡伶撤凸峡耘化悸祁看烃鸡截誉哈骨科术后静脉血栓的预防与护理骨科术后静脉血栓的预防与护理 VTE的预防与护理 防重于治，防患于未然 DVT是源，PTE是果，没有DVT 很少发生PTE 预防DVT就是预防PTE 妊摘铡辈竣舵乃怪凛爆秽装澳棠佬界办糖敛附寂撩饼买虚陡脂所蔫痴贿萧骨科术后静脉血栓的预防与护理骨科术后静脉血栓的预防与护理 骨科血栓预防专家建议 基本预防措施 物理（机械）预防措施 药物预防措施 联合预防 基本预防 机械预防 药物预防 联合预防 嗜啼惋锤梨婿港耽择栖僵霄撮俞侈稗日腾鸿迭甚训茧挑扫适钞胖伸赛丈惰骨科术后静脉血栓的预防与护理骨科术后静脉血栓的预防与护理 Company Logo L o g o L o g o Company Logo Company Logo Company Logo Company Logo Company Logo Company Logo Company Logo Company Logo There is a very strong association between pulmonary embolism (PE) and deep vein thrombosis (DVT): - 90% of pulmonary emboli are the results of DVT - A recent study showed that 82% of patients with acute PE had detectable DVT at the time PE was diagnosed. - Silent PE occurs in more than 50% of patients with symptomatic proximal DVT. As the venous clot in the leg grows it extends along the vein. DVT can develop into a chronic condition in which damage to the valves in the veins results in swelling of the leg, pain and venous hypertension (known as post-thrombotic syndrome - PTS) Parts of the clot can also detach, travelling in the blood to block vessels in the lungs, subsequently causing pulmonary embolism (PE). If less than 50% of the pulmonary circulation is blocked, symptoms are generally limited to shortness of breath or are absent altogether. Very large emboli, however, can cause massive blockage of the pulmonary circulation and rapidly lead to death. 1. Pesavento R, Lusiani L, Visona A, et al. Prevalenza di embolia polmonare clinicamente silente nella trombosi venosa profonda degli arti inferiori.