| Objective:This study was to provide the basis for the prevention of high-risk VTE(venous thrombo embolism) patients,Traditional Chinese Medicine diagnosis and treatment to VTE patients, treatment options, long-term treatment and prevention of recurrence, giving full play to the treatment of traditional Chinese and western medicine etc. And also, to improve the cure rate of DVT(deep venous thrombosis) patients, reduce the occurrence of PE(pulmonary embolism) and PTS(post-thrombotic syndrome, PTS), and conduct clinical research of VTE.Methods:VTE cases in Sichuan Provincial Hospital of Traditional Chinese Medicine from November 2012 to March 2015 were analyzed retrospectively. Cases were retrieved according to current diagnostic criteria, and with the help of inclusion and exclusion criteria, these cases were divided into four types:DVT cases, PE cases, DVT complicating with PE cases and PTS cases.Results:264 VTE cases distributed in 14 departments were collected in this study, in which,131 were male and 133 were female. With respect to age, the minimum was 17, maximum 96 and median was 59. The top five department in terms of recruited case numbers were respectively Cardiovascular Surgery (201 cases),Respiratory (12 cases), Orthopaedic (11 cases),Oncology (10 cases),and Emergency department(7 cases).The main symptoms of DVT patients were swelling limbs,pain,limitation of activity,skin temperature changes,cacochroia, blisters,numbness,ulcers and so on. The main symptoms of PE patients were dyspnea,cough,chest pain,fever,hemoptysis and so on. The main reasons of PTS patients were swelling limbs,pain,pigmentation,varicose superficial vein,ulcers,itching,limitation of activity and so on. Tongue and pulse manifestation:common performance of DVT and PTS was reddish tongue, thin white moss, deep fine pulse; PE was red tongue, yellow greasy moss, wiry and thin pulse.Those patients who took detection of D-dimmer were 103 cases,D-dimmer≥500ug/L were 71 cases(68.93%), D-dimmer<500ug/L were 32 cases (31.07%).There were 86 cases(27.61%) complicated with hyperlipidemia, and the higher triglycerides 58 cases.Patients who took Venous doppler ultrasound inspectors were 202 cases,in which the positive result were 187 cases (92.57%).72 cases took lower limb vein phlebography of which 72 cases(100%) were positive results.While 16 cases were iliac vein venous thrombosis,30 cases were iliac vein occlusion.Some of PE patients took CT pulmonary angiography,the positive results was 46.15%, all of which were pulmonary artery segment embolism or above.50 cases took the treatment of thrombolysis with anticoagulant, in which 20 cases (40.00%) to be cured,29 cases (58.00%) were improved and 1 case (2.00%) was invalid, cases 173 cases took the treatment of anticoagulant, in which 5 cases (2.89%) to be cured,157 cases (90.75%) were improved and 11 cases (6.36%) were invalid.257 cases took treatment of Chinese medicine,36 cases treatmented only by Chinese medicine.In the 36 cases,there were 33 cases (91.67%) were improved and 3 cases (8.33%) were invalid.It need 5.56±4.55 days for simplex traditional chinese medicine to work.Anticoagulant therapy need 3.82±2.72 days to develop efficiency.It need 2.04±1.382 days for thrombolysis with anticoagulant therapy to take effect.Thrombolysis with anticoagulant therapy developed efficiency faster than anticoagulation(P=0.000), anticoagulation developed efficiency faster than simplex Chinese medicine treatment(P=0.007).Conclusion:VTE is one of the common diseases in Sichuan Traditional Chinese Medicine Hospital, which is easy to miss diagnosis or misdiagnosis, because of distributing in many departments, mainly elderly patients, merging a variety of basic diseases, inducing by many factors, lack of characteristic in clinical manifestations. Assistant examination:PE takes pulmonary angiography as priority. DVT and PTS take doppler ultrasound and angiography as priority. D dimer has reference significance to the VTE diagnosis. However, these examinations have certain limitations or are invasive, especially when peripheral pulmonary artery thrombosis has no typical imaging performance, which should be diagnosed according to the clinical manifestation, laboratory examination, the effect of treatment and so on. Although traditional Chinese medicine treatment works a little later in the early treatment than thrombolysis or anticoagulation therapy, it has obvious effect, especially for those patients with thrombolysis and anticoagulation western taboo. Therefore, it is necessary to improve the understanding about VTE and regulate the administration of VTE, especially strengthen the study on large sample of Chinese medicine in the treatment of VTE。... |
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