Clinical Study of Deep Vein Thrombosis of Lower Limbs

Abstract

Understanding the natural history of venous thrombosis is important for optimal management of this condition. Once risk factors are recognized it is possible to avoid these risk factors or to use active prophylaxis to reduce the morbidity and mortality. This study is targeted at identifying the risk factors of deep vein thrombosis in our set up, the role of Heparin in prophylaxis and to do a comparative study of low molecular weight Heparin with unfractionated Heparin in treatment of deep vein thrombosis of lower limb in Guru Gobind Singh Government hospital, Jamnagar. Material and Methods: Study population consisted of 50 consecutive patients with deep vein thrombosis, admitted to Guru Gobind Singh hospital, Jamnagar. We have studied 50 patients above 18 years of age with proven deep venous thrombosis by Doppler ultrasound. A complete clinical history was taken to assess risk factors, level of immobility if present and thorough physical examination was done. Routine investigations such as hemogram, haematocrit, blood indices, and liver and renal function tests were done. Diagnosis of deep vein thrombosis was detected by radiographic imaging like Doppler ultrasonography. Results: In our study, most of patients presented with complaints of swelling (70%) and pain (48%) of the affected lower limb. Few patients (4%) had symptoms of breathlessness (SOB), chest pain and orthopnea suggestive of pulmonary embolism. 34 patients in our study were having reasonably good level of haemoglobin while rests of all were having anaemia of different degree4 patients had haemoglobin below 8gm/dl and that needed separate treatment also. Leukocytosis was present in 16 patients. 16 patients had smoking as associated risk factor along with other acquired risk factors and 5 patients had obesity along with other risk factors. The most common complication of DVT is pulmonary embolism which occurs due to dislodgement of thrombus. Conclusion: Even though it is grievous, DVT can be prevented and treatable. Better and regular availability of drugs like LMWH and safer oral anticoagulants in the smallest possible region of the country can do wonders to save lives. Larger studies focusing more on coagulation cascade, molecular biology and genetics will be even bigger help to mankind.