Single-center Preliminary Statistical Analysis Of Hospitalized Patients With Venous Thromboembolism

Venous thromboembolism is a common disease of surgical field,its incidence is on the rise year by year,especially in hospitalized patients.Venous thromboembolism not only has high fatality rate,its complications also seriously affect the patients quality of life,and bring huge economic burden to patients and social.Therefore,studies of venous thromboembolism etiology,diagnosis and treatment were published,and made great achievements.According to reports in the literature,the patients with acute venous thromboembolism who had not diagnosed had a fatal pulmonary embolism risk at any time.There were few patients with acute venous thromboembolism who accepted treatment had no serious complications,for most patients,regardless of accepting conservative treatment,invasive surgery or interventional treatment,would have different degrees of complications,severe cases can be life-threatening.Therefore,the most effective treatment of venous thromboembolism is prevention.About the prevention of venous thromboembolism have reported in some literature,but at present,China's perception of the disease is not enough,and cannot be carried out in accordance with the relevant guidelines,which made its incidence on the rise year by year.Therefore,how to improve people's understanding of venous thromboembolism is becoming a hot spot of clinical problems,so as to reduce the incidence of the disease.What kind of treatment accepted by venous thromboembolism patients and what factors after discharge can influence the occurrence of the complications,which have been discussed and upgraded.Objective:To analyze the high risk factors of venous thromboembolism and the prevention accepted of hospitalized patients retrospectively,to explore the effect of different treatments and medication adherence on discharged patients' prognosis.Methods : From February,2015 to August,2016,78 cases with hospitalized patients with venous thromboembolism were treated in the Second Hospital of Hebei Medical University.To clear the diagnosis through the lower limb vein ultrasound,lower extremity venous imaging and CT pulmonary angiography.Rating the risk factors carried of patients with a history of inside,surgery in hospital according to Padua criteria and Caprini criteria,and recording preventive measures they accepted.To record the treatment accepted and the thigh,calf weeks diameter difference between trouble and healthy side thigh from in hospital to out of the hospital.To record medication adherence of discharged patient and the signs and symptoms of lower limbs by phone or outpatient follow-up.To assess the incidence and severity of post-thrombotic syndrome according to the Villalta and record complications such as bleeding,recurrence and so on.Results : Seventy-eight patients with venous thromboembolism had a history of hospitalization in six weeks ago,sixty-three cases with a history of surgical,including 7 cases of line gynecological tumor surgery,seven cases of cerebral surgery,seventeen cases of orthopaedic surgery,thirteen cases of tumors,nine cases of cesarean section surgery,six cases of regular surgical cases,four cases of varicose veins surgery.And 15 cases with a history of medicine,including 3 cases which had a history of active tumor,four cases had a history of cerebral infarction,one case with infection,one case had a history of department of gynaecology,four cases of a history of cardiology,one case had a history of pregnancy,and there were other medical history in 1case.Accepting the preventive measures accounted for 37.18%,only 21.79%in patients with adequate prevention.seven patients accepted catheter directed thrombolysis,thirty-eight patients who received thrombolysis in peripheral system,thirty-three patients accepted pure anticoagulant therapy,fifteen patients received inferior vena cava filter during the period of hospitalization.The symptom was improved when all patient out of hospital.The thigh,calf weeks diameter difference between trouble and healthy side thigh from in hospital to out of the hospital is statistically significant(P<0.05).The degree ofsymptoms relief of each kind of treatment options between the tow groups of patients of center type,mixed type has no statistical difference(P >0.05).Seventy-eight cases were followed up,the follow-up was 4 months-22 months.The average follow-up time was 12.77±5.23 months,forty-one patients 'medication compliance was better,thirty-seven patients who did not adjust the medication according to the coagulation results,and 16 cases of patients stop anticoagulation after discharge.Fifteen patients developed into PTS,including mild lesions in 11 cases,moderate in 4 cases.Three patients recurred.Three patients died,two cases due to the deterioration of the primary disease,one case with brainstem hemorrhage.Conclusion:The proportion of risk factor of venous thromboembolism statisticed by Second Hospital of Hebei Medical University has a deviation with the guide.At present our country has failed to assess and grad the risk factor of venous thromboembolism properly of hospitalized patients.The hospitalized patients with venous thromboembolism risk factors failed to get effective prevention.To suggest catheter contact thrombolysis therapy when the illness permits.The medication adherence effects the prognosis and related complications of discharge Patient.