Retrospective Analysis Of Therapeutic Effect On Patients With Isolated Calf Intermuscular Vein Thrombosis And Intracerebral Hemorrhage

Background The statistics of deep vein thrombosis(DVT)show that its incidence rate is as high as 20%-70%,which is one of the common complications of cerebral hemorrhage patients.Failure to timely treatment will increase the mortality and disability rate of patients,Hospitalization time and medical burden increase,and the quality of life decreases.Data show that deep vein thrombosis in the lower extremities accounts for more than 90%.Isolated calf deep vein thrombosis(ICDVT)refers to deep vein thrombosis(DVT)confined below the knee joint.The clinical manifestation is local tenderness of the calf.The most common is no obvious swelling,Conscious symptoms such as pain.Data show that 31% to 56% of DVT is ICDVT.Deep vein thrombosis may cause pulmonary embolism with the blood flow.Pulmonary embolism is one of the clinical critical illnesses.If it is not treated in time,it may endanger the life of the patient.Therefore,how to prevent the formation of deep vein thrombosis is the acute stage of cerebral hemorrhage patients.The most important challenges facing the recovery period.According to statistics,about 5% of patients with cerebral hemorrhage died of pulmonary embolism.Although the incidence of ICDVT is high,anticoagulation therapy for patients with cerebral hemorrhage may cause increased hematoma volume,increased stress ulcer and gastrointestinal bleeding,and increased risk of skin and mucosal bleeding.Most patients with cerebral hemorrhage are complicated with hemiplegia and disturbance of consciousness,and have the objective needs of early rehabilitation exercise.Some studies believe that early functional rehabilitation of patients with isolated calf muscle vein thrombosis can promote thrombolysis and absorption.Therefore,it is still controversial whether patients with cerebral hemorrhage combined with isolated calf muscle venous thrombosis(ICMVT)undergo anticoagulant therapy,acute phase rehabilitation and limb function exercise,and there is no unified conclusion,and the current domestic related issues Lack of prospective controlled studies.Objective The purpose of this study was to compare the effects of low-molecular-weight heparin calcium anticoagulation and exercise on the treatment of isolated calf muscle vein thrombosis and cerebral hemorrhage.Method 164 patients with intracerebral hemorrhage with solitary inter-muscle venous thrombosis diagnosed from January 2015 to December 2019 in Puyang Oilfield General Hospital were selected as the first onset.According to the treatment wishes of patients and their families,they were naturally divided into groups:(1)80 cases in the anticoagulation group(42 males and 38 females);(2)84 cases in the exercise group(46(1)males and 38 females).Anticoagulation group: Give low molecular weight heparin calcium 85IU/kg,subcutaneous injection every 12 hours,the affected limb brake,treatment for 14 days.(2)Exercise group: Active and passive movements of the ankle,knee and hip joint of thrombus side calf are used to evaluate the patient's tolerance level and gradually increase the movement range.Nursing staff use uniform standard training.Follow-up follow-up was conducted after discharge from the hospital.The follow-up period was 3 months.The color Doppler ultrasound of the venous vessels of the lower extremities was collected on 7,14,21,and 90 days.Rate,incidence of stress ulcers,bleeding rate of skin and mucous membranes.Results(1)In the anticoagulation group(n=80),there were 0 cases of thrombosis progression,5 cases of cerebral hemorrhage progression,including 1 death,10 stress ulcers,and 2 skin mucosa bleeding.(2)In the exercise group(n=84),8 cases developed thrombosis,2 cases developed pulmonary embolism,1 case developed cerebral hemorrhage,and 2 cases developed stress ulcer.There were 0 cases of thrombosis progression in the anticoagulation group and 8 cases(9.5%)in the exercise group,and there was a statistical difference between the two groups(P <0.05);10 cases(12.5%)of stress ulcers occurred in the anticoagulation group,exercise There were 2 cases(2.4%)of the treatment,and there was a statistical difference between the two groups(P <0.05);5 cases(6.3%)of cerebral hemorrhage progressed in the anticoagulation group and 1 case(1.2%)of the cerebral hemorrhage progression in the exercise group,There was no statistical difference between the two groups(P>0.05);there were 17 cases(21.3%)of bleeding events in the anticoagulation group and 3 cases(3.6%)of the bleeding events in the exercise group,and there were statistical differences between the two groups(P<0.05).0.05);between groups,there were 2 cases(2.5%)of skin and mucosal bleeding in the anticoagulation group,and 0 cases of skin and mucosal bleeding in the exercise group.There was a statistical difference between the two groups(P <0.05).Conclusion 1.Low molecular weight heparin anticoagulation has obvious advantages in controlling the progress of thrombosis,and can significantly inhibit the progression of isolated muscular vein thrombosis to deep vein thrombosis or pulmonary embolism.2.Low molecular weight heparin anticoagulation can increase the risk of hemorrhagic events(stress ulcers,skin and mucous membrane bleeding);but its increased risk of intracranial hemorrhage progression is not statistically different from the exercise group.