Objective To analyze the relation between the mode of delivery and postpartum lower extremity deep venous thrombosis （DVT）， and discuss the therapy methods. Methods The clinical data of 48 patients with postpartum lower extremity DVT from 2006 to 2012 in this hospital were analyzed retrospectively. Results There were 15 897 patients with the delivery， of whom were 10 097 cases of cesarean section and 5 800 cases of spontaneous delivery， the incidence rate of lower extremity DVT in the patients with cesarean section was significantly higher than that in the patients with spontaneous delivery〔0.41% （41/10 097） versus 0.12% （7/5 800）， χ2=9.94，P＜0.005〕. The higher incidence rate of cesarean section， the higher incidence rate of lower extremity DVT， which was a positive correlation between them （rs=0.87，P＜0.05）. Forty-three cases were only treated by drug therapy， 2 cases were performed operation combined with drug therapy， and 5 cases were placed the inferior vena cava filter. Forty-eight cases were cured and discharged. Conclusions The incidence rate of lower extremity DVT of cesarean section is higher as compared with the spontaneous delivery. The thrombolysis and （or） anticoagulation therapy is an effective way in the treatment for DVT. Controlling indications of cesarean section and early postpartum out-of-bed can decrease the DVT.
目的 比较常规使用肝素和阿加曲班治疗下肢深静脉血栓（DVT）患者的临床疗效。方法 将188例下肢DVT患者按照随机数字表分成阿加曲班组（n=94）和对照组（低分子肝素钙+尿激酶，n=94），比较2组患者治疗前、后双侧肢体周径差和疗效的差异，并在治疗过程中监测凝血指标（PT、APTT及PLT）变化。结果 阿加曲班组治疗10 d后，双侧肢体周径差较治疗前明显减小（Plt;0.05），总有效率（97.87%）优于对照组（89.37%），Plt;0.05。阿加曲班组无血小板减少症（HIT）发生，对照组发生2例HIT； 阿加曲班组PT、APTT和PLT变化均处于正常范围，与对照组比较差异无统计学意义（Pgt;0.05）。结论 阿加曲班治疗下肢DVT安全、有效。
ObjectiveTo summarize strategy of diagnosis and treatment of thrombotic iliac vein stenosis in recent years.MethodThe relevant literatures in recent 5 years on the current status and trend of diagnosis and treatment of the thrombotic iliac vein stenosis were reviewed.ResultsAt present, the diagnostic methods of thrombotic iliac vein stenosis mainly included that the multi-slice spiral CT, venography, intracavitary ultrasound, magnetic resonance imaging, color Doppler ultrasound and other imaging examinations, each of which had its advantages and disadvantages. There were still no uniform criteria whether a filter should be placed, whether the stents should and how to be placed, and when to intervene in the patients with acute thrombotic iliac vein stenosis. There was no definite conclusion when and how to effectively intervene in the patients with chronic thrombotic iliac vein stenosis.ConclusionsIncidence of thrombotic iliac vein stenosis is high and sequela is severe. Early diagnosis and reasonable treatment are very important. Only strictly grasping indications, combining medical technology and patient’s condition, and adopting appropriate treatment strategy, can make patients’ maximal benefit.
Objective To establish a model of deep venous thrombosis (DVT) in rats for dynamic study of antithrombotics or thrombolysis on thrombosis. Methods SD rats (n=60) were randomly divided into thrombosis model group (n=36), control group (n=18) and sham operation group (n=6). An improved method was used to make the inferior caval vein ligated in SD rats of thrombosis model group. After operation, rats in thrombosis model group and control group were divided into 6 period groups. The changes of thrombus and internal surface of vessels in each period were observed in thrombosis model group and were compared with those in other two groups, respectively. Results Stable venous thrombus were observed in all inferior caval vein in thrombosis model group, and the proximal part of venous thrombus was unobstructed and consistent with the pathological change of venous thrombosis during acute stage in human body. Conclusion The DVT model in rats was successfully established, which maybe helpful for dynamic study of the effect of antithrombotics or thrombolysis on thrombosis.
ObjectiveTo summarize the new biomarkers of deep venous thrombosis (DVT) and their research progress, so as to provide new ideas for the prevention, diagnosis and treatment of DVT. MethodThe literature about biomarkers of DVT in recent 5 years was reviewed and summarized. ResultsAccording to the results of literature review, a variety of common DVT biomarkers such as serum microrna, fibrin monomer, neutrophil capture net, and E-selectin were sorted out, but most of them had not been used in clinical DVT management. At present, the clinical diagnosis of DVT required the combination of positive D-dimer test and positive imaging examination, and there was no single biomarker for the diagnosis of DVT. ConclusionsBiomarkers are valuable in the diagnosis and treatment of DVT, but their sensitivity and specificity need to be optimized. Therefore, finding biomarkers with more diagnostic value is one of the future directions. At the same time, we also can consider fully combined with a variety of existing biomarkers, to improve the efficiency to the diagnosis of DVT.
ObjectivesTo systematically review the efficacy and safety of catheter-directed thrombolysis (CDT) versus anti-coagulation (AC) for deep vein thrombosis (DVT). MethodsWe searched PubMed, EMbase, The Cochrane Library, Web of Science, WanFang Data and CNKI databases to collect randomized clinical trials (RCTs) about CDT versus AC for DVT from inception to March 2018. Two reviewers independently screened literature, extracted data and evaluated the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software. ResultsA total of 5 RCTs and 989 patients were included. Meta-analysis showed that there was no significant difference between the two group in incidence of post-thrombotic syndrome (RR=0.73, 95%CI 0.49 to 1.09, P=0.13), iliofemoral venous patency rate (RR=2.57, 95%CI 0.59 to 11.24, P=0.21), bleeding (RR=2.03, 95%CI 0.50 to 8.28, P=0.32), severe bleeding (RR=1.77, 95%CI 0.91 to 3.42, P=0.09) and recurrence rate of venous thromboembolism (RR=1.00, 95%CI 0.42 to 2.36, P=0.99). However, the incidence of moderate-severe PTS decreased in CDT group was lower than that in the control group (RR=0.70, 95%CI 0.53 to 0.92, P=0.01). ConclusionsCompared with the control group, catheter-directed thrombolysis does not reduce the incidence of PTS and VTE recurrence rate, cannot improve the long-term patency of the iliofemoral vein, yet can prevent the occurrence of moderate to severe PTS. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.