| Venous thromboembolism(VTE)mainly includes deep vein thrombosis(DVT)and pulmonary embolism(PE).With the continuous improvement of the understanding and the diagnosis technology of VTE,the diagnosis rate of VTE is increasing year by year,and the inpatients are the majority.The diagnosis rate of VTE is increasing year by year,and it is one of the highly fatal diseases,mainly due to PE.In addition,VTE will also bring a long-term sequelae burden to patients,which will seriously affect the physical and mental health of patients,and bring great economic burden to patients' families and society.In this regard,clinicians have conducted in-depth explorations of their pathogenesis and diagnosis and treatment methods in the early stage,and have achieved excellent results.Based on this,they have formulated corresponding guidelines and consensus to significantly improve the level of diagnosis and treatment of VTE.However,according to relevant literature reports,even after standard anticoagulation treatment,VTE will develop nearly half of patients with post-thrombotic syndrome(PTS).Therefore,prevention of VTE is more important.And with the continuous development of preventive medicine,clinical attention has also been paid to VTE.Multi-centers have established their own "VTE prevention and control system".Our center also complete the "VTE prevention and control system" 3 years ago,to attempt to reduce the incidence of such diseases from the root cause.According to the statistical analysis of the preliminary data of our department,we learned that the incidence of VTE in the inpatients in our center has not been significantly controlled,and even increased compared with 3 years ago.Is this phenomenon related to the improvement of diagnostic technology and diagnostic awareness,or is it due to the poor practicality of the VTE prevention and control system? How to make our center's "VTE prevention and control system" more practical and targeted,so that all departments can benefit from it,become the focus of follow-up work.Objective:1.To calculate the trend of VTE incidence of inpatients in our center in recent years,and analyze the effectiveness and practicability of our center's VTE prevention and control system;2.To count the changes trends of VTE incidence and the prevention of the implementation of various departments in the inpatients of our center,who transferred to our department for further treatment.To indirectly analyze the implementation status and effect and the standardization of the VTE prevention and control system in each department.And making targeted guidance and improvement to achieve individualized prevention programs for different diseases,and make this "VTE prevention and control system" more practical and targeted.Through statistical analysis of the relevant data of the undergraduate departments,we could indirectly evaluate and analyze the effect of the implementation of the "VTE prevention and control system" of the center in the hospital,and the status and effect of the implementation of the "VTE prevention and control system" in each department.Methods: To statistics and analysis the medical records of 203 patients with acute VTE who had a history of hospitalization in our center from January 2017 to December 2019.All patients were diagnosed assisted by lower extremity venography and lower extremity venous ultrasound or computed tomographic pulmonary angiography(CTPA).The occurrence of newly diagnosed VTE patients,who admitted to our center during this period in our department,was counted and compared with the previous data.The above patients were grouped according to their original inpatient department,and the occurrence of VTE and the prevention of VTE in each group were counted.VTE risk factors were scored for inpatients according to the Caprini scoring criteria,and the VTE risk factors were counted,as well as the prevention and adequate prevention rates.Based on the above statistical results,the effectiveness of our center's "VTE Prevention and Control System" and the implementation status of each department were evaluated and analyzed,and proposed the improvement measures.Results: From January 2017 to December 2019,a total of 203 patients with a history of hospitalization in our center and secondary acute VTE were included.1.In 2017,2018 and 2019,the proportion of patients who had a history of hospitalization and occurrence of acute VTE in the undergraduate department of the hospital accounted for 17.18%,15.48%,13.73% of all inpatients of VTE,respectively.The annual rate was 15.46%,which was higher than the 14.58% in 2016.2.Among them,there were 10 cases of central lesions annually,accounting for 14.71%,mixed lesions 30.67 cases,accounting for 45.99%,peripheral lesions 27 cases,accounting for 39.31%.The rate of peripheral lesions increased significantly compared with the previous 28.57%.3.The acceptance rate was 53.18%,which was significantly higher than that 38.10% in 2016.However,the adequate prevention rate 23.56% was not significantly improved.Conclusion: According to the statistics of the preliminary data of our departments,although the occurrence of VTE in the inpatients treated by the our department has increased compared with the previous date,but it has shown a declining trend year by year.Which was related to the improvement of the cognition and diagnostic technology of VTE.Although the rate of acceptance of prevention has improved significantly,especially for low-risk and intermediate-risk patients,but the improvement of the rate of acceptance of adequate prevention was not significant,mainly due to irrational preventive measures and the lack of standardized preventive measures.It can be seen that our center's "VTE prevention and control system" has certain clinical application value,but it still lacks pertinence and standardization.It needs to be further improved and promoted to standardize preventive measures,especially in some emerging departments. |
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