Lower Deep Venous Thrombosis Research Articles

Application of sequencing nursing based on Caprini Assessment Scale for DVT risk assessment in perioperative period of stroke patients

Objective To explore the risk grading of deep venous thrombosis (DVT) based on Caprini Assessment Scale and the application value of sequencing nursing according to the risk level in perioperative period of stroke patients. Methods A total of 136 stroke inpatients treated in Nanshi Hospital of Nanyang from January to December 2016 were selected as the control group, and given routine nursing of stroke and general prevention measures for DVT. Another 152 stroke inpatients admitted during January to December 2017 were selected as the observation group. The Caprini Assessment Scale was used for DVT risk classification, and the programmed countermeasure was taken. The nursing effects were compared between the two groups. Results The peak venous blood flow velocity, the mean blood flow velocity and the mean blood flow of affected lower limbs of the observation group were significantly higher than those of the control group after the intervention (P<0.05) . The incidence rates of lower limb swelling, skin color change of lower limbs and DVT in the observation group in perioperative period was 11.18%, 8.55% and 4.61% respectively, which were significantly lower than those in the control group (39.71%, 30.14% and 26.47%) , and the differences were statistically significant (P<0.001) . The hospitalization time of the observation group was significantly shorter than that of the control group, and the nursing satisfaction was obviously higher than that of the control group (P<0.01) . Conclusions The DVT risk classification based on Caprini Assessment Scale and programmed countermeasure can reduce the incidence of DVT, shorten the hospitalization time and improve the nursing satisfaction of stroke patients. Key words: Stroke; Venous thrombosis; Caprini assessment scale; Sequencing nursing

Blood Viscosity Response to Specific Electrical Acupoint Stimulation Post Colorectal Tumor Surgery.

Lower deep venous thrombosis (DVT) is one of the major complications of patients with tumors or patients undergoing major surgery. Electrical acupoint stimulation, an established technique of traditional Chinese medicine, can be well combined with Western medicine to reduce the incidence of postoperative DVT, especially in elderly patients1. Purpose: The purpose of the study was to determine the effect of electrical acupoint stimulation on blood viscosity of patients undergoing colorectal tumor surgery. Subjects and Methods: Thirty patients who had malignant colorectal tumor stage A ,B,C and D undergoing elective surgery for that tumor selected randomly and divided into two equal groups. Group 1 include 15 patients that received standard traditional physical therapy postoperative care from the first day after surgery for 1 week. Group 2 include 15 patients who received the same treatment as group1 plus electrical acupoint stimulation from the first day after surgery for 1 week. Blood viscosity in both groups were assessed using platelet count, prothrombine concentration and color duplex study of the blood flow velocity in the veins of lower limbs. Results: The results of this study showed significant decrease in the blood viscosity of lower limb veins in the group 2 that used electrical acupoint stimulation over group 1(P value < 0.001) . Conclusion: It was concluded that electrical acupoint stimulation is an effective method to increase blood viscosity and hence decrease the incidence of DVT after colorectal tumor surgery.

Two cases of pulmonary thromboembolism associated with protein C and protein S deficiency and literature review

To explore the clinical manifestations, diagnosis and treatment of pulmonary thromboembolism associated with protein C (PC)/protein S (PS) deficiency. Two male patients 29 and 26 years old diagnosed with PC deficiency and/or PS deficiency were retrospectively analyzed and related literatures were reviewed. The most common symptoms were pain in the lower limbs with chest pain or decreased vision. Color dopper flow imaging (CDFI) showed lower deep venous phlebothrombosis. Multislice CT angiography (CTA) revealed pulmonary embolism. The level of serum homocysteine (HCY) increased and the level of plasma PC/PS content decreased to PC 57.4%, and PS 28.9% in patient 1, while PS 33.4% in patient 2. Poor routine anticoagulant response was observed. After the diagnosis of PC/PS deficiency, vitamin B6 and B12 anticoagulant therapy was added, and the symptoms in the patients improved significantly. Congenital thrombophilia should be taken into consideration for young patients with lower deep venous thrombosis and pulmonary embolism which occur recurrently without obvious predisposing causes before 40. Plasma PC/PS concentrations or activity help a lot in the diagnosis and treatment.

Preventive Effect of Electrical Acupoint Stimulation on Lower-Limb Thrombosis

Lower deep venous thrombosis (DVT) is one of the major complications of patients with tumors or patients undergoing major surgery. Electrical acupoint stimulation, an established technique of traditional Chinese medicine (TCM), can be well combined with Western medicine to reduce the incidence of postoperative DVT, especially in elderly patients. The objectives of this study were to assess the efficiency of electrical acupoint stimulation in the prevention of postsurgery DVT in elderly patients with gastrointestinal malignant tumors and to validate an effective and safe nursing approach that integrates TCM and Western medicine. A total of 120 patients (none aged <60 years) who underwent malignant gastrointestinal tumor surgery between July 2005 and May 2007 were randomly divided into 3 groups: routine nursing group (group C1), graduated compression stockings group (group C2), and electrical acupoint stimulation group (group T). Hemorheological parameters (blood viscosity, etc) were measured and compared before and after surgery. Compared with groups C1 and C2, group T showed a significant difference in blood viscosity and blood flow velocity (P < .05). However, there were no statistical differences among groups C1, C2, and T in other hemorheological parameters. By speeding up the blood flow in patients' lower limbs, electrical acupoint stimulation showed a great potential to prevent symptomless DVT in elderly patients after malignant gastrointestinal tumor surgery. Western medical care combined with TCM can reduce the occurrence of lower DVT in elderly patients suffering from gastrointestinal cancer. This approach may help nurses to plan effective care for elderly patients.